GPSN Evaluation Survey Report 2009 by GPRA Publications

GENERAL PRACTICE STUDENTS NETWORK

THE GENERAL PRACTICE STUDENTS NETWORK PROGRAM EVALUATION REPORT OCTOBER 2009

The GPSN would like to thank our foundation sponsor MDA National for supporting our organisation and in particular the GPSN Schwartz First Wave scholarship program. In addition, we would like to thank General Practice Education and Training (GPET) for their ongoing support of our organisation, enthusiasm for medical students and commitment to the future of Australian General Practice. Lastly, we acknowledge the Hon. Nicola Roxon MP and theDepartment of Health and Ageing for their support of this initiative.

Table of Contents

Overview of the General Practice Students Network

Research Background & Objectives

Summary of Key Findings & Recommendations

Limitations

Research Methodology

(IQSKVETLMG 4VS½PI SJ 6IWTSRHIRXW

Detailed Findings

7.1 General Practice

7.1.1 Current Preferred Career Choice

7.1.2 Attitudes Towards General Practice

7.1.3 GP Rotations

7.1.4 Awareness of General Practice Training, Colleges and RTPs

7.2 The General Practice Students Network (the GPSN)

7.2.1 Awareness of the GPSN

7.2.2 GPSN Events

7.2.3 GPSN Publications

7.2.4 Overall Effectiveness of the GPSN

Appendices

Appendix A – Survey Questionnaire

Appendix B – Overall Attitude Towards General Practice as a Career Verbatim Responses

Overview of the General Practice Students Network

The General Practice Students Network

+472 MW XLI ½VWX REXMSREP WXYHIRX organization with a focus on General Practice. The GPSN’s primary role is to function as a General Practice interest group, WIIOMRK XS TVSQSXI XLI FIRI½XW SJ E PMJI ERH career in General Practice.

There are active GPSN “clubs” at 20 medical university campuses across Australia. Membership to the organization has grown steadily since it was established in 2007; at the time the survey was conducted, there were a total 3,638 GPSN members. The GPSN is led by the GPSN Executive. The Executive manages national operations and consists of the Chair, ViceChair and National Secretary. 8LI +472 )\IGYXMZI PIEHW XLI +472 'SYRGMP [LMGL MRGPYHIW One GP Student Ambassador (GPSA) from each Australian medical school 3RI )\IGYXMZI 3J½GIV JVSQ IEGL %YWXVEPMER QIHMGEP WGLSSP One Secretary from each Australian medical school

The GPSN provide a range of educational and professional resources of interest to all medical students including academic events, professional development events, social events, an e-newsletter, website, medical students’ guide and a scholarship.

8LI +47% )\IGYXMZI 3J½GIV ERH 7IGVIXEV] VYR XLI PSGEP GPSA club for their medical school. General Practice Registrars Australia (GPRA), the peak body for GP Registrars, provides administrative support to the GPSN.

8LI WTIGM½G QMWWMSR ERH SFNIGXMZIW SJ XLI SVKERM^EXMSR EVI XS Empower medical students to make informed decisions in choosing their future vocation Seek to correct misconceptions about General Practice 4VSQSXI XLI FIRI½XW SJ +IRIVEP 4VEGXMGI EW E GEVIIV Champion the importance of General Practice’s role in the overall medical landscape The GPSN was founded by General Practice Registrars Australia (GPRA) and the Australian Medical Students Association (AMSA). The GPSN is administered by GPRA ERH ½RERGMEPP] WYTTSVXIH F] +IRIVEP 4VEGXMGI )HYGEXMSR ERH Training (GPET). The original idea for the GPSN came from medical student and General Practice enthusiast Joe Rotella, who was the GPSN’s founding Chair.

Research Background & Objectives

As a means of evaluating the effectiveness of the GPSN in promoting General Practice GPRA undertook a survey amongst medical students around Australia.

In relation to the GPSN: Awareness of GPSN and how heard about the GPSN GPSN membership status Attendance to GPSN events Feedback on the GPSN e-newsletter and medical student guide ‘ASPIRE’ Effectiveness of the GPSN in promoting awareness of General Practice and General Practice training Impact of the GPSN on likelihood of considering General Practice as a career

+MZIR XLEX XLMW MW XLI ½VWX IZEPYEXMSR SJ XLI +472 XLI MRXIRXMSR is that the 2009 survey results will function as a benchmark for future waves of the survey. Comparative results will enable GPRA and GPET to measure any changes in students’ attitudes towards General Practice, and thus the effectiveness of the GPSN, over time.

Demographics: Year of medical training Pre-clinical or clinical Age, gender, university Aboriginal or Torres-Strait Islander Household situation

The 2009 GPSN Student Survey sought to benchmark awareness, knowledge and attitudes towards the GPSN and General Practice amongst medical students. Other factors known to impact on student perceptions of General Practice were also measured.

In addition to gathering the views of medical students who were GPSN members, feedback was also sought from medical students who were not members in order that differences in perceptions and attitudes towards General Practice could be compared between the two groups.

7TIGM½GEPP] XLI WYVZI] MRWXVYQIRX QIEWYVIH XLI JSPPS[MRK In relation to General Practice: Current preferred career choice and other specialties considering Knowledge of General Practice as a specialty Knowledge of General Practice training Attitude towards General Practice Impact of GP rotations or placements on attitudes towards General Practice -QTEGX SJ SXLIV MR¾YIRGIW I K SXLIV QIHMGEP WXYHIRXW hospital staff and family GP) on perceptions of General Practice Awareness of the Australian General Practice Training program (AGPT), RTPs, the RACGP and ACRRM.

Summary of Key Findings & Recommendations

As an organization set up to promote the FIRI½XW SJ E PMJI ERH GEVIIV MR +IRIVEP Practice amongst the medical student TSTYPEXMSR MR %YWXVEPME XLI FIRGLQEVO ½RHMRKW of the 2009 GPSN Student Survey, suggest that the organization is off to a great start.

appears to be a function of how long students are into their medical training. When it comes to the channels by which the GPSN employs to engage its members, the survey results suggest that things are indeed moving in the right direction, although some areas for improvement did emerge. The GPSN appears to be doing a great job promoting itself to medical students across the country, with as high as 58% of non-members also aware of the organization. Further students are hearing about the organization through a breadth of resources, including the local Student Ambassadors (37%), via word of mouth (33%) and at lecture announcements (15%), but particularly through the range of events that local GPSN clubs run on campus (42%). Events such as workshops, (38%), lunches (35%) and GP experience-type events (33%) being the most well-attended GPSN events.

With as high as 53% of members indicating that they now have a better understanding of what’s involved in becoming a GP since joining the GPSN, the organization appears to be making great inroads in assisting students to make an informed decision with regards to their future vocation. The GPSN’s effectiveness is also evidenced in the fact that as high as one in every three members (34%) stated that they are now ‘more likely’ to consider General Practice as a career since joining the GPSN, with less than 1% saying they are now less likely to consider General Practice.

Whilst the GPSN is doing a good job engaging with its members through the various events local clubs organize, there does appear to be a need for more events to be run on campuses. There also appears to be a need for events to focus on certain aspects relating to the profession of General Practice.

The GPSN also appears to be doing a great job in promoting awareness of the Australian General Practice Training program (AGPT) and of the Colleges; awareness of the AGPT program is as high as 93% amongst members who are personally involved in the organization and at 67% amongst all other GPSN members, whereas awareness is at 59% amongst non-members. Similarly whilst prompted awareness of the Royal Australian College of General Practitioners (RACGP) is uniformly high across all students (96% total), awareness of the Australian College of Rural and Remote Medicine (ACRRM) is WMKRM½GERXP] LMKLIV EQSRKWX QIQFIVW TIVWSREPP] MRZSPZIH MR XLI GPSN (95%) and all other GPSN members (76%) as compared to non-GPSN members (61%).

Over half of the respondents (52%, which included members, those personally involved in the organization and those not sure if they were members) had attended at least one GPSN event or activity organized by their local GPSN club – a higher proportion should probably be sought in future. Further, whilst around half ‘agreed’ that the GPSN has provided information about General Practice training pathways (56%) and insights into the opportunities available through General Practice (57%) – relatively few ‘strongly agreed’ that this was the case. A similar pattern of results emerged in relation to the GPSN providing opportunities to see presentations from established GPs (48%), to attend clinical workshops (44%) and to network with other QIHMGEP WXYHIRXW [MXL PIWW XLER SRI MR ½ZI ³WXVSRKP] agreeing’ for each).

Awareness of most of the Regional Training Providers (RTPs) across the county, however, is an area that could be earmarked for improvement by the GPSN. Provided with a list of all RTPs, as high as 45% of respondents admitted to not having heard of any – members who were personally involved in the GPSN however were by far the least likely group to have not heard of any RTP (7%), with non-members the most likely to have not heard of any (56%). At this point in time awareness of RTPs

-R EHHMXMSR XS IRWYVMRK XLEX E WYJ½GMIRX RYQFIV SJ IZIRXW EVI run on campuses to enable interested students to attend, the

3 | Summary of Key Findings & Recommendations

General Practice. Whilst the results indicated that 41% were more likely to pursue a career as a GP following completion of their GP rotation around one in ten (12%) indicated being deterred from the profession following their rotation(s).

results also highlighted the need for events to focus on certain aspects about General Practice moving forward. 1IHMGEP WXYHIRXW MR KIRIVEP RS[ ETTIEV XS FI WYJ½GMIRXP] E[EVI SJ XLI FIRI½XW ERH VI[EVHW E GEVIIV MR +IRIVEP 4VEGXMGI GER bring, including the lifestyle and continuity of care with patients, as well of the importance of General Practice in the delivery of healthcare in Australia. However perceptions that it is not as GLEPPIRKMRK ½RERGMEPP] VI[EVHMRK SV EW LMKLP] VIKEVHIH EW SXLIV specialties are common, even amongst those students who feel positive about General Practice as a career choice; this was FSVRI SYX MR FSXL XLI UYERXMXEXMZI ERH UYEPMXEXMZI ½RHMRKW JVSQ the survey.

Rotations that expose students to the diversity and scope of work that is possible in General Practice, involve positive and enthusiastic Supervisors supervising students and get students involved in some activity as opposed to being passive observers, can do much to dispel misconceptions about General Practice. Opportunities of this nature is the aim of the GPSN Schwartz First Wave Scholarship Program. In addition to GP rotations, students perceptions of General 4VEGXMGI [SYPH SFZMSYWP] EPWS FI MR¾YIRGIH XS WSQI I\XIRX by the views of others. Whilst most of the types of people students would speak to about General Practice (e.g. university teaching staff, their family and friends) are either ‘mostly positive’ about General Practice or ambivalent about it, negative perceptions do exist amongst the various groups. Of note is that other medical students (29%) is one of the main groups to have a ‘mostly negative’ view of General Practice, thus there is still work cut out for the GPSN in addressing misconceptions amongst the student population. The results also revealed that not all GP Registrars are positive in their views of General Practice. The fact that only around half (52%) were perceived as having a ‘mostly positive’ view amongst respondents suggests a need for further exploration, particularly given that GPRA, through its various initiatives, encourage students to look to Registrars as positive role models.

Integrating more ‘myth-busting’ sessions into GPSN events, a method which has been employed with great success by the GPRA in other forums, could be one option for more WTIGM½GEPP] EHHVIWWMRK WYGL TIVGITXMSRW 1SVI XEPOW JVSQ +4W who have pursued diverse special interests, as well as more comprehensive and/or hands-on information about what GPs can earn could also comprise a key component of future GPSN activities. Information such as this may assist in taking General Practice to the next level in the minds of more medical students. It is important to note that all local GPSN club executives, including the National Executive, are full-time medical students who volunteer their time to the GPSN. Thus the support provided by GPRA in assisting clubs with their event management and coordination, as well as in their relations with stakeholders, will play a vital role in enabling individual clubs to meet the needs of their respective members. Formal procedures which reward and recognize the efforts of local Student Ambassadors and their teams will also be important in sustaining the student network moving forward. Whilst the GPSN can do much to continue to promote the FIRI½XW SJ E PMJI ERH GEVIIV MR +IRIVEP 4VEGXMGI MX WLSYPH EP[E]W be recognized that the GPSN can only play a role in this regard. The results from students who had completed GP rotations point to the fact that negative experiences on GP rotations do ETTIEV XS EPWS WXVSRKP] MR¾YIRGI WXYHIRXW´ TIVGITXMSRW SJ

Limitations

Perhaps the main limitation of the 2009 GPSN Student Survey was the selection bias inherit in the survey sample. Although effort was made to get as many members and nonmembers of the GPSN to complete the survey, the methods by which GPRA were able to distribute the survey to medical students (i.e. email invitation to GPSN members, invitation to respond via GPSN eNewsletter and distribution to nonmembers via GPSN Student Ambassadors) means that there was an obvious selection bias towards non-members. The channels of distribution employed resulted in the limited sample that was achieved amongst non-members (14% of the total sample). A more even sample would enable comparisons between members and non-members, and thus provide greater insight into the effectiveness of the GPSNâ&#x20AC;&#x2122;s activities in shifting perceptions and attitudes towards General Practice. A higher response rate from most universities should also be sought in future to enable reliable comparisons between universities and thus enable insight into the effectiveness of the GPSN at different universities. A strong marketing strategy that promotes the survey to both members and non-members of the GPSN amongst medical students across university campuses will be needed to achieve the robust sample required to make the desired analyses in 2010. Gaining access to the most up-to-date medical student databases (e.g. via medical student societies and/or sponsoring or stakeholder organizations), should form part of this strategy. GPRA are also currently seeking to document the number of medical students that are studying at each university in order to determine the penetration of GPSN membership by university. This will provide further insight as to the effectiveness of the GPSN and where the most work is needed.

Research Methodology

The research was conducted via an online survey and carried out by GPRA. Students were invited via email to click into a survey link to complete the survey. The survey instrument was developed by GPRA in consultation with GPET and consisted of a combination of closed and openended questions; the survey thus provided both quantitative and UYEPMXEXMZI ½RHMRKW WII %TTIRHM\ % JSV XLI WYVZI] UYIWXMSRREMVI The survey was promoted by a number of means to ensure that a broad scope of medical students completed the survey. Namely; GPRA sent an email invitation to all GPSN members on its database GPRA asked all GPSN Student Ambassadors to distribute the invitation to as many medical students at their respective universities as they could (e.g. by posting a link to the survey from the university’s student forum site) Students were invited to complete the survey via the GPSN monthly e-Newsletter The survey period ran for a period of 5 weeks, from Friday 29 May to Thursday 2 July 2009, to allow ample opportunity for students to take part in the survey. GPRA also ran a weekly prize draw, with the prize being a $150 Coles Myer gift voucher, to encourage uptake of the survey. Only medical students enrolled in a medical course in Australia were eligible to complete the survey. A total of 1,278 medical students from 20 universities GSQTPIXIH XLI WYVZI] 8LI HIQSKVETLMG TVS½PI SJ XLI WXYHIRXW who responded is provided in the next section (Section 6).

(IQSKVETLMG 4VSÂ˝PI SJ Respondents

The sample included respondents from all 20 medical schools in Australia, thus the survey achieved a good reach. Having said this, greater responses would need to be sought from students at particular universities in future waves of the survey if reliable comparisons between universities are to be made.

The majority of the students who responded were in IMXLIV XLIMV Â˝VWX WIGSRH SV XLMVH ]IEV SJ WXYH] ERH correspondingly, most were undertaking their pre-clinical studies (59%).

There was somewhat of an over-representation from students at the University of Adelaide (14.7% of the total sample) and those from James Cook University (12.4%), whilst only a handful of Bond University students took part in the survey. Universities with large medical student cohorts were also underrepresented, particularly those from the University of Sydney, University of Queensland, University of Melbourne and Monash University.

% WQEPP TVSTSVXMSR SJ VIWTSRHIRXW MHIRXMÂ˝IH XLIQWIPZIW EW Aboriginal or Torres-Strait Islander (1%) and some were parents (6%), however most were single with no children (60%).

Most of the students who took part in the 2009 GPSN Student 7YVZI] [IVI JIQEPI [LMGL MW TEVXP] VIÂžIGXMZI SJ XLI higher proportion of females studying medicine in Australian universities, and most (71%) were aged 18 to 24 years of age.

Whether respondents were GPSN members or not was also captured. Around two-thirds (67%) were GPSN members or members who were also personally involved in the organization. At the time the survey was conducted (from 29 May 2009), there were 3,638 GPSN members. With a total 837

8EFPI 'YVVIRX 8VEMRMRK University Australian National University Bond University Deakin University Geelong Flinders University +VMJÂ˝XL 9RMZIVWMX] James Cook University Monash University University of Adelaide University of Melbourne University of New England Year of Medical Training 1st year 2nd year 3rd year Pre-Clinical or Clinical Pre-clinical

% 5.6 0.4 2.8 5.1 7.7 12.4 4.9 14.7 2.6 3.2

n 72 5 36 65 98 159 63 188 33 41

University of New South Wales University of Newcastle University of Notre Dame Fremantle University of Notre Dame Sydney University of Queensland University of Sydney University of Tasmania University of Western Australia University of Western Sydney University of Wollongong

% 5.6 4.9 2.4 2.3 3.9 1.4 9 3.7 2.7 4.6

n 71 62 31 30 50 18 115 47 35 59

26.4 26.9 20.7

337 344 265

4th year 5th year 6th year

11.0 7.2 7.8

140 92 100

59.2

756

Clinical

40.8

522

Base: All Respondents (n=1,278)

` (IQSKVETLMG 4VSÂ˝PI SJ 6IWTSRHIRXW

8EFPI 4IVWSREP (IXEMPW Gender Male Female Age Group Under 18 18 - 24 25 - 30 31 - 40 41 - 50 Over 50

% 32.9 67.1

n 406 829

2.0 70.9 18.9 6.4 1.6 0.2

25 875 234 79 20 2

Aboriginal or Torres-Strait Islander Yes No Household Situation Single Single with child/children In a relationship, not living together Married or Defacto Married or Defacto with child/children

% 0.9 99.1

n 11 1,224

59.6 0.6 22.7 12.2 4.9

733 7 279 150 60

Base: All Respondents. Note: 43 respondents did not provide a response, results based on n=1,235, except â&#x20AC;&#x2DC;Household Situationâ&#x20AC;&#x2122;, n=1,229

8EFPI +472 1IQFIVWLMT 7XEXYW

members completing the survey, a response rate of 23% was achieved amongst GPSN members. The remaining respondents were non-members (14%) or not sure if they had signed up as members (19%).

GPSN Membership Yes, I am a member Yes, Iâ&#x20AC;&#x2122;m a member and personally involved in the organization No, Iâ&#x20AC;&#x2122;m not a member Maybe, not sure if Iâ&#x20AC;&#x2122;ve signed up as a member or not

Of note, is that three-quarter of the GPSN members who VIWTSRHIH XS XLI WYVZI] [IVI MR XLIMV Â˝VWX XLVII ]IEVW SJ medical school; this is an indicator of the reach of the GPSN todate. Namely, the GPSN has been most successful in capturing or attracting students in their early years of medical training.

% 63.8 3.5

n 794 43

14.2 18.6

177 231

Base: All Respondents. Note: 33 respondents did not provide a response, results based on n=1,245

Also of note is that most respondents who indicated being personally involved in the organization (63%) were in either their second or third year of medical training â&#x20AC;&#x201C; this indicates, and supports anecdotal observations, that students who have had time to settle into university life are most interested, and probably best-positioned, for GPSN executive positions.

Detailed Findings

This section of the report presents the detailed Â˝RHMRKW JVSQ XLI +472 7XYHIRX 7YVZI] Unless otherwise indicated, the results are based on the responses of all respondents. Noteworthy differences in the results between any groups (e.g. members vs. non-members) are highlighted in the written results.

7.1.2 Attitudes Towards General Practice When asked how they felt towards General Practice as a career choice (see Chart 2 on page 13), the vast majority (72%) indicated feeling positively towards General Practice â&#x20AC;&#x201C; EPFIMX SRP] SRI MR Â˝ZI JIPX ÂłZIV] TSWMXMZIÂ´ XLI UYEPMXEXMZI results from the proceeding question lent some insight into this result. Those personally involved in the GPSN were the most likely to feel â&#x20AC;&#x2DC;very positiveâ&#x20AC;&#x2122; about General Practice (40%) and non-members the least likely to feel this way (12%).

7.1 General Practice

Respondents were also asked to state in their own words why they felt the way they did about General Practice.

7.1.1 Current Preferred Career Choice 6IWTSRHIRXW [IVI EWOIH XS MRHMGEXI XLIMV Â˝VWX WIGSRH ERH XLMVH preferred career choice from a list of specialties; Chart 1 on page 13 presents these results. ;LIR EPP Â˝VWX WIGSRH ERH XLMVH GLSMGIW EVI XEOIR MRXS consideration, General Practice emerged as the most preferred specialty, with 54% of all respondents choosing General Practice as one of their top three specialties. General Practice was followed by Medicine (Hospital Medicine) (39%) and Emergency Medicine (35%). Of note is that General Practice was considerably more likely to feature amongst GPSN membersâ&#x20AC;&#x2122; top three preferred career choices as compared to that for nonmembers (58% members vs. 42% for non-members).

It was clear from a review of the responses that many YRHIVWXERH ERH EVI E[EVI SJ XLI FIRIÂ˝XW ERH VI[EVHW SJ E career in general practice, such as the lifestyle that can be had, variety of work and continuity of care with patients. However it was also clear that, even amongst those positive about General Practice as a career choice, that the various perceived disadvantages or drawbacks of the profession, such that it is not as challenging as other specialties, is undervalued, and not as well remunerated as other specialties, prevent many medical students from viewing General Practice as a career choice in a â&#x20AC;&#x2DC;very positiveâ&#x20AC;&#x2122; light. That suburban General Practice is not as interesting or challenging as rural General Practice was a common perception, as was the view that General Practice may perhaps not suit oneâ&#x20AC;&#x2122;s personality or that it is simply not the profession for them. Negative experiences on GP placements, what theyâ&#x20AC;&#x2122;ve heard from others, as well as what they see occurring across the General Practice landscape, also appear to have shaped some respondentsâ&#x20AC;&#x2122; less positive perceptions about the profession. The hardships of rural General Practice also featured as a concern for many.

;LIR SRP] Â˝VWX GLSMGIW [IVI XEOIR MRXS GSRWMHIVEXMSR +IRIVEP Practice also emerged as the most popular choice amongst all respondents (22%) which was followed by Surgery (15%). Again, members were more likely to indicate General Practice [EW XLIMV Â˝VWX GLSMGI XLER [IVI RSR QIQFIVW XLI QSWX TSTYPEV Â˝VWX GLSMGI EQSRKWX RSR QIQFIVW [EW Surgery (19%). A considerable proportion of all respondents (18%) stated being undecided as to their career direction which is perhaps not surprising given that most respondents were only in their Â˝VWX WIGSRH SV XLMVH ]IEV SJ WXYH]

On page 14 is a sample of some of the sort of responses that were provided by rating; Appendix B contains a more extensive list of sample responses by rating.

7 | Detailed Findings

'LEVX 'YVVIRX 4VIJIVVIH 'EVIIV 'LSMGI

Q4: Please indicate which of the following (if any) is your current preferred career choice? Base: All Respondents (n=1,278). Note: the results shown in Chart 1 are based on actual values, not percentages 'LEVX 3ZIVEPP %XXMXYHI XS[EVHW +IRIVEP 4VEGXMGI EW E 'EVIIV 'LSMGI

Q5. How would you rate your overall attitude towards General Practice as a career choice? Base: All Respondents (n=1,250) 13

“It’s a good lifestyle, shorter training program, more opportunity to focus on an area of interest (e.g. sporting injuries, OG, sexual health).”

Q6. Can you tell us why you gave the above rating? Base: All Respondents (n=1,052) Respondents who rated their overall attitude towards General Practice as a Career Choice as ‘Very Positive´

“Over the past few months my perceptions towards General Practice as a career has been changing. I began medicine convinced I did not want to be a GP, but after attending GPSN information nights and clinical placements I’m appreciating positives such as patient relationships, diversity of presenting cases etc. However I chose ‘mostly positive’ because I really have no idea what my ultimate career choice will be.”

“Being able to interact with patients, their families and the community on the personal level of their health as they progress through life would be one of the most rewarding jobs I can think of.” “I grew up in a country town and was exposed to amazingly skilled GPs whom I aspired to be like. I love the variety and GLEPPIRKI SJ +IRIVEP 4VEGXMGI MR EHHMXMSR XS MXW ¾I\MFMPMX] ²

“Well I love General Practice – but it lacks procedural work. Becoming a rural Generalist enables me to be a GP with additional procedural skills.”

“My impression and experiences of General Practice show it to be a rewarding career, with a large array of presenting problems and patients and a high degree of patient contact and a good lifestyle.”

±1EMRP] ERIGHSXEP FYX TSWMXMZIW MRGPYHI ¾I\MFMPMX] MR [SVO hours, easy access into training programs, lifestyle. Negatives MRGPYHI MRXIPPIGXYEP GLEPPIRKI MR TEVXMGYPEV ½IPHW SJ MRXIVIWX and pay (with regards to amount of work vs. pay received).”

“I like the idea of being a ‘pillar of the community’ - working long-term in a community, seeing people from all walks of life with a range of problems, and following patients as they grow up. I also believe that preventative health and health education is one of the most important aspects of improving the health of Australians and is best delivered through General Practice.”

±-X WIIQW XS FI E ZIV] ¾I\MFPI GEVIIV [MXL KVIEX PMJI WX]PI Also a good choice for women with child-bearing age.” ±-R E VYVEP WIXXMRK +4 GER FI E ZIV] HMJ½GYPX GEVIIV TEXL EW there is not much support and you could be the only GP in a single town. This is a little stressful and worrying! However it is a very diverse career path which interests me.”

Respondents who rated their overall attitude towards General Practice as a Career Choice as ‘Mostly Positive´

Respondents who rated their overall attitude towards General Practice as a Career Choice as ‘Neither Positive nor Negative´

“I really enjoyed a recent GP placement, so I feel a lot more positive towards General Practice. I have heard that as a female GP particularly, half of what you do is pap smears... I do realise that this is an exaggeration, however it would MR¾YIRGI Q] HIGMWMSR XS FIGSQI E +4 ²

“I haven’t had much exposure to clinical practice yet, hence can’t make a judgment.” “It has its pros and cons. While I would love the hours and patient contact, the lack of use of skills I have learned...and challenging procedures/cases I think would get boring...and make doing 4 years of medicine seem almost like a waste.”

“General Practice seems like a good lifestyle choice and the variety would be good. I’m not sure if it would be as challenging intellectually compared to treating multivariable, complex cases as a hospital physician.”

“Not sure I want to sit in a tiny room pumping patients XLVSYKL IZIV] QMRYXIW ERH HIEPMRK [MXL ¾Y ERH IPIZEXIH BP and depression all day, every day in an urban GP practice – boring!”

“It allows you to have a broad range of exposure to different aspects of medicine and I think there is a lot more continuity of care in a GP setting.”

7 | Detailed Findings

“Managing chronic diseases and forwarding interesting patients onto other people doesn’t interest me.”

“Is a good solid career however the scope seems a little small, such that it seems there isn’t quite a lot of variety compared to other specialties.”

“Huge time constraints on care delivery; has become largely a referral service; long hours seeing many patients for relatively poor remuneration.”

“Not enough incentive to be a GP – you’re over-worked. Also less ability to be a small business owner in the current environment. In the past most GPs owned their own practice, but now GPs are fast becoming employees of businesses who happen to own a GP practice.”

“Does not particularly suit my personality. I prefer procedural/surgical modalities of work.” ±- ½RH XLI [SVO HYPP QE]FI FIMRK E QIHMGEP WXYHIRX WMXXMRK MR XLI GSVRIV SJ E +4´W SJ½GI JSV LVW E HE] JSV [IIOW bored to distraction, probably didn’t help.”

“Other specialisations seem to be more interesting. Even though General Practice is not just ‘coughs and colds’, GPs appear as some sort of gatekeeper, who refers the patient to others when it gets too hard. It seems like the ‘real’ science occurs with physicians and surgeons. My parents are GPs, so I also know that GPs have a similar work load to other specialties yet they aren’t as well reimbursed ½RERGMEPP] EW XLI SXLIV WTIGMEPXMIW ;LMPI XLEX MW RSX Q] main motivation, it shows that the GP’s time is not as valuable as other specialties.”

“10 years working in the rural for international student doesn’t seem appealing.” Respondents who rated their overall attitude towards General Practice as a Career Choice as ‘Very Negative´ “Too much promotion and exposure to GP has turned me off it. It’s all we ever hear about and we get sick of it.”

“I am a New Zealand citizen and have to do the 10 year moratorium. If I choose GP, I have to work in a rural or remote area for 10 years otherwise I do not have a provider number.”

“From own experience with General Practitioners and also family friends that are General Practitioners. Also, I ½RH XLI [SVO XLEX +4´W HS JVSQ QMRMQEP I\TSWYVI XS be rather boring.”

±8LI GEVIIV SJ +IRIVEP 4VEGXMGI WIIQW PMQMXIH ERH GSR½RIH to a normal boring day job compared to the hospital environment for most junior medical students.”

“Seems like a highly stressful job that isn’t adequately remunerated for the effort required.” “I do not like the job scope of a GP, especially the continuing care aspect.”

Respondents who rated their overall attitude towards General Practice as a Career Choice as ‘Mostly Negative´

Whether medical students consider General Practice a specialty and whether they know if it requires additional, specialist training was measured (see Table 4 on page 16).

“I can think of pros and cons but overall there are more suitable options ahead of General Practice on my list. General Practice sounds isolating – less teamwork and interaction with fellow professionals. A lot of aspects of patient care that are not particularly ‘medical’.”

There were very few respondents who did not consider General Practice to be a specialty in its own right (<2%) and a similar proportion (2%) were not aware that General Practice requires further training after internship.

“Enjoy the variety, challenges and patient interaction. On the other hand, many city GPs seem to dislike aspects of their jobs – e.g. bureaucracy, red tape, the whinging well, etc.”

8EFPI /RS[PIHKI SJ +IRIVEP 4VEGXMGI EW E 7TIGMEPX] +4 8VEMRMRK

Q7. We’d like to get an idea of what you know about General Practice. From what you understand… Base: All Respondents (n=1,250) as a rewarding and important profession that provides good lifestyle options have been largely successful. However, perhaps future activities require more focused exposure on aspects which relate to the prestige of a profession, such as the remuneration, complexities and diversity or scope that is possible; greater understanding and/or awareness of these may take General Practice to the next level in the minds of more medical students.

These results suggest that these aspects regarding General Practice have been promoted effectively to medical student audiences to date. It should also be noted however that the prompted nature of these items may have contributed to the overly positive response. 6IWTSRHIRXW [IVI EPWS WYJ½GMIRXP] E[EVI SJ XLI FIRI½XW E career in General Practice can bring and in its importance in the delivery of healthcare in Australia (see Table 5 on page 17). In particular, it was almost uniformly agreed that General Practice plays an important role in the long-term healthcare of patients (<100% ‘strongly agree/agree’), that it is central to the delivery of quality healthcare in Australia (96% strongly agree/agree) and that one can enjoy the continuity of care with patients that is lacking in other specialties (89% strongly agree/agree).

Î Myth-busting workshops may be a good forum for promoting these aspects of General Practice, as well as more talks from GPs who have pursued diverse special interests; more comprehensive and/or on- hands information about what GPs can earn could also comprise a key component of future GPSN activities. Some respondents (n=74) provided additional comments in support of their ratings to the presented statements, a sample SJ XLIWI MW TVIWIRXIH FIPS[

The majority of respondents also agreed that you can enjoy a healthy work-life balance as a GP (83% strongly agree/agree). 6I¾IGXMRK VIWTSRHIRXW´ TVIZMSYW ZIVFEXMQ GSQQIRXW XLIVI was less total agreement with the statements that General Practice is just as challenging as other specialties (78%), that ]SY GER IEVR E WYJ½GMIRX MRGSQI [LMPWX XVEMRMRK ERH [SVOMRK EW a GP (77%) and that General Practice offers the opportunity to pursue diverse special interests (73%) (those personally involved in the GPSN were the most likely to ‘strongly agree’ with these statements).

±-X´W ZIV] HMJ½GYPX XS ½RH SYX TE] WGEPIW JSV +4´W ² “People ask me: ‘So are you going to be only a GP or a specialist?’ I have started to explain to them that it is a specialty in itself and requires 3-4 years training. I would like FRACGP to become more visible and educate people that GPs are specialists who undertake a long training. I would like an effort in changing peoples’ perspectives.”

Î These results, coupled with respondents’ ratings of General Practice as a career choice and associated comments, suggest that efforts to raise awareness of General Practice

“It seems to me that the only way to earn a reasonable income as a GP is to see 5 patients an hour every hour

7 | Detailed Findings

8EFPI %XXMXYHIW 8S[EVHW +IRIVEP 4VEGXMGI

Q8. Please rate the extent to which you agree with each of the following statements about General Practice. Base: All Respondents (n=1,250)

and not stop for breaks. If you actually want to spend time with patients and provide good service I don’t think the pay is very good (but not 100% sure).”

“I would like to know how much GPs’ can earn in different areas – rural vs. metro, full time vs. part-time, special interests vs. general.”

“Not sure of income as GP Registrar.”

“I think there is a common misconception about the pay of GP’s amongst medical students. Most see it also as not a ‘sexy’ specialty, when the reality is that 50% of students will be GPs in the future anyway.”

“We really don’t get any information about income as a student, but perhaps this is a good thing and shouldn’t be guiding students’ career choices.”

“All of these things are true, but it’s hard to get all of them EX XLI WEQI XMQI *SV I\EQTPI HMJ½GYPX XS EGLMIZI E [SVO life balance whilst creating a specialty interest and earning a good income.”

“I’ve heard that a healthy work-life balance and high GP income are mutually exclusive...” ±9RWYVI EFSYX XLI TVSGIWW UYEPM½GEXMSRW SJ ³WYF WTIGMEPM^EXMSR´ [MXLMR +IRIVEP 4VEGXMGI [SYPH PMOI XS ½RH SYX QSVI ²

“General Practice is most important for the health care system. Without GP’s we’ll turn into the United States and SYV )6 [MPP FIGSQI ¾SSHIH ²

“I believe that in an ideal world General Practice is central to delivering quality healthcare in Australia, however, realistically GP’s seem to have very limited time to spend with their patients because of the community GP : patient ratio, and I feel strongly that this prevents GP’s from providing the best quality of care.”

When respondents were asked how they would rate others’ views on General Practice (see Table 6 on page 19), it would appear that in general, most people medical students speak to are either mostly positive about General Practice or ambivalent; there was no source that was ‘mostly negative’ about General Practice for the most part.

“General Practice is incredibly important, but has inappropriate stigmas attached to it as being ‘the easy way out’ or ‘the only thing women doctors can be’. This is a view that needs to be broken down in the medical schools.”

The results suggest that one’s own GP (66%), university teaching staff (63%), family members (54%) and GP Registrars (52%) are the most likely to be ‘mostly positive’ about General Practice. Hospital staff (44%), interns (42%) and doctors not in General Practice (40%) were more likely to be neither positive nor negative. Those most likely to be negative in their views of General Practice were doctors’ not in General Practice (34%), followed by other medical students (29%). The fairly high proportion of respondents (minimum of 23%) who could not comment on the views of hospital staff, interns, GP Registrars and medical mentors, should be noted.

“General Practice is about improving quality of life for patients rather than ‘saving the life’ of patients.” “I’m not sure that you can enjoy a healthy work-life balance as a country GP, but apart from that I agree that you can.” “With the advent of super clinics, continuity of care seems to be becoming a thing of the past...” “With regards to the third part of question 8, I think it depends on the circumstances of your job. For example, if you are the only GP in a small town, I’m sure this balance would be slightly tipped.”

Î The fact that around one in every four respondent rated other medical students’ views about General Practice as ‘mostly negative’ indicates that much work is still needed by the GPSN to address misconceptions about General Practice amongst the medical student population.

“Appointments with GPs are often very short and so only deal with one ‘presenting problem’, overall lifestyle factors (i.e. primary healthcare) do not seem to be dealt with.”

7 | Detailed Findings

8EFPI %XXMXYHIW SJ 3XLIVW 8S[EVHW +IRIVEP 4VEGXMGI Q9. Weâ&#x20AC;&#x2122;re interested to hear about what factors have shaped your perceptions about General Practice as a career choice. You may have heard things about General Practice from other people. For each of the following, can you please rate what their views about General Practice have been like? Base: All Respondents (n=1,250)

8EFPI +4 6SXEXMSR W )\TIVMIRGI Started or Completed GP Rotation as Part of Training No, I have not started or completed a GP rotation

% 58.1

n 726

Yes, I have started or completed a GP rotation Location of GP Rotation(s) Metropolitan Rural or Remote I have completed both a metropolitan and a rural or remote rotation I have not yet completed any rotation

41.9

524

30.9 34.6 29.0 5.4

160 179 150 28

Q10. Have you started or completed a GP rotation or placement as part of your training yet? Base: All Respondents (n=1,250) Q11. If you have completed a GP rotation, in which demographic was it done? Base: Those respondents who had completed a GP rotation (n=517)

can do much to encourage interest in General Practice; rotations in rural settings in particular appear to do a good job of this.

Ă&#x17D; That only 52% of respondents perceived GP Registrars as being â&#x20AC;&#x2DC;mostly positiveâ&#x20AC;&#x2122; about General Practice, and that a fairly high proportion were perceived as being ambivalent (14%) is also some cause for concern. GP Registrars are one of the main groups that GPRA encourage medical students to look to as role models (e.g. in myth-busting sessions and the GPSN Schwartz First Wave Scholarship Program). Student perceptions of GP Registrar attitudes and how they interact with Registrars, could be one area to be explored further with students in future waves of the survey.

Responses also highlighted the importance of positive and enthusiastic Supervisors, supportive and encouraging environments, as well as getting students involved in activities as opposed to having them be passive observers on rotations. 7IIMRK Â˝VWX LERH XLI PMJIWX]PI XLEX GER FI IRNS]IH MR +IRIVEP Practice also appears to be an important component of a positive and inspiring rotation.

7.1.3 GP Rotations Respondents were asked a series of questions to ascertain their level of involvement in GP rotations or placements and how these experiences have impacted on their attitudes towards General Practice.

Q14. Can you tell us why gave the above answer? Base: Those respondents who had completed a GP rotation (n=326) Sample of verbatim responses from respondents who indicated being â&#x20AC;&#x2DC;More Likelyâ&#x20AC;&#x2122; to pursue a career in General Practice JSPPS[MRK GSQTPIXMSR SJ XLIMV +4 VSXEXMSR W

Just over 40% of all respondents had either started or completed a GP rotation and there was a fairly even split with regards to where respondents had completed their rotations across metropolitan, rural/remote or both locations (see Table SR TEKI 1SWX IRGSYVEKMRK MW XLEX JSYV MR Â˝ZI SJ XLI respondents who had a completed a GP rotation of some nature (81%) enjoyed a mostly positive experience (see Chart 3 on page 21).

â&#x20AC;&#x153;The rural GP placement was fantastic and demonstrated that one can be a GP but also work in the hospital as well.â&#x20AC;? â&#x20AC;&#x153;The GP I was placed with was very enthusiastic, eager to teach and passionate about General Practice.â&#x20AC;? â&#x20AC;&#x153;The GP I worked with was a nice guy who loves his job and explained to me how rewarding it is being a GP.â&#x20AC;?

Also encouraging is the fact that after having completed their GP rotation, most respondents indicated that they were either now more likely to pursue a career in General Practice (41%) or that they were still interested in pursuing this career path (25%). Of some concern is that around one in ten respondents (12%) indicated being less likely to pursue General Practice following completion of their rotation indicating a negative experience was had (see Chart 4 on page 21).

Âą8LI TPEGIQIRXW GSRÂ˝VQIH [LEX - EPVIEH] ORI[ ÂŻ obviously as a student, you are sometimes required just to sit and observe, which can be quite boring, however being the GP in the â&#x20AC;&#x2DC;hot seatâ&#x20AC;&#x2122; will be quite different to being the student observing. The better experiences were when GPs allowed me to actually see patients and do some minor procedures.â&#x20AC;? â&#x20AC;&#x153;Saw a wide variety of complaints from many patients in different demographics; observed the close relationship between the GP and their patients.â&#x20AC;?

Respondents were also asked why they felt the way they did with regards to pursuing General Practice as a career following completion of their rotation.

â&#x20AC;&#x153;I saw the real diversity and challenges of General Practice particularly in the more remote areas.â&#x20AC;?

The responses of those who indicated being more likely to pursue a career in General Practice following their rotation highlighted how a rotation that exposes students to the diversity and scope of work that is possible in General Practice

â&#x20AC;&#x153;I could really imagine myself doing it.â&#x20AC;?

7 | Detailed Findings

'LEVX 3ZIVEPP +4 6SXEXMSR )\TIVMIRGI

Q12. How would you rate your GP rotation experience overall? Please note: if you have completed more than one GP rotation, please provide an overall rating. Base: Those respondents who had completed a GP rotation (n=523) 'LEVX 3ZIVEPP +4 6SXEXMSR )\TIVMIRGI

Q13. Since completing your GP rotation(s), would you say you are now more likely or less likely to pursue a career as a GP? Base: Those respondents who had completed a GP rotation (n=523)

“I worked with several different GPs as part of my year last year. It was interesting to note how different GPs approached similar problems and the different personality types of patients each GP attracted. The experience showed me that General Practice can be a vibrant career that is only as dull as you want it to be.”

“First-hand experience has given me a better idea of what the profession entails.” “Since I did my placement in a rural area – it gave me an idea of the wide range of things GPs are involved in. The GPs were also very enthusiastic and willing to let us try most things.”

“I was involved in all aspects of the practice, I was given the opportunity to follow up patients over a long period of time, and I was exposed and allowed to conduct professional clinical skills in a safe learning environment.”

“The challenging aspect of having a career in General Practice interests me as well as the opportunity to have a good work-life balance.” “In my 3 GP placements I’ve seen a wide spectrum of General Practice. One of the GPs I worked with was awful, practicing outdated medicine on very unmotivated patients. One enjoyed her job, but tended to refer on very quickly. 8LI ½REP +4 - [SVOIH [MXL S[RIH E QSHIVR [IPP WIX YT practice with excellent staff. He did theatre lists once a [IIO ERH QEREKIH IZIR GSQTPI\ GEWIW LMQWIPJ 8LI ½REP GP has made me see that work satisfaction can be gained if you practice in a certain way. Also, he played golf twice a week and drove a really nice sports car.”

“I was placed in a large GP practice and was able to sit in with all the doctors in the practice. Whilst they were all GPs they all had different areas of special interest and worked different hours to suit themselves. I really liked the ¾I\MFMPMX] ERH XLI STTSVXYRMX] XS JSGYW SR EVIEW XLEX WYMXIH your interests. The doctors in the practice all worked well together and it was a good learning environment for a student or Registrar to ask questions.” “I realised that the scope of a GP’s work was a lot wider XLER - ½VWX XLSYKLX ²

“Thoroughly enjoyed it – got to do a lot of different activities – not the same thing every day.”

The verbatim comments from respondents who gave a ‘About the same, still interested in being a GP’ rating in relation to how likely they would be to pursue a career as a GP following completion of their GP rotation, yielded an array of responses. Some did not necessarily enjoy positive rotations but were still interested in General Practice, whilst others indicated still being interested in General Practice, in addition to wanting to WII [LEX SXLIV ½IPHW LEH XS SJJIV &IPS[ MW E WEQTPI SJ XLIWI ZIVFEXMQ VIWTSRWIW

“The GP I was with was a very happy man and enjoyed working with his patients who reciprocated his pleasant nature. In the past I have met GPs that hate their job and in turn their patients do not like them as much.” ±- WE[ XLI ¾I\MFMPMX] SJ XLI GEVIIV XLI GLERGI XS KIX SYX SJ the hospital system, and realised the pay was better than initially thought.”

“I know a little bit more about General Practice now that I am doing a GP rotation. I like what I see, but I still want to experience other areas before I decide.”

“One of the GPs gave me a real enthusiastic picture of General Practice, always telling me it can be whatever you make it to be, and gave me heaps of hands-on practice at it which I thoroughly enjoyed as I actually felt like I was part of the team rather than a useless tag-along.”

“Didn’t really see that much. I would like a bit more hands on exposure rather than watching.”

“I liked seeing the relationship the doctors had with their patients, especially when they were looking after a whole family and multiple generations.”

“I was passionate about this before I did my placement, and my placement did not turn me off the idea.”

7 | Detailed Findings

“I have had positive experiences in General Practice but still have not had experience in a wide range of areas to which to compare my General Practice experiences to.”

±- WE[ ½VWX LERH XLI [SVOMRK PMJI SJ +4W I\TIVMIRGIH ER array of patients presenting. I don’t want my days to be ½PPIH [MXL XLEX X]TI SJ HSGXSV TEXMIRX MRXIVEGXMSR ²

“My brief rotation was enjoyable as all things were new and interesting, however the GP I was placed with really didn’t feel that he would stay working as a GP for much longer. I KYIWW - WE[ LMW JVYWXVEXMSR ERH PEGO SJ HVMZI ERH MHIRXM½IH with his reasoning because I experienced the same feelings when I changed career to do medicine. As a fella with a family, I appreciated that General Practice can be a great career in medicine, however I fear that I will reach the same point this gentleman has.”

“I have always been drawn to hospital medicine and acute care medicine.” “Seems like a very stressful job.” ±'SR½VQIH XLSYKLXW EPVIEH] LIPH VIKEVHMRK +4 PERH ² “GP placements are very varied, depending on the GP you’re with. Most of the time I just sat in the corner. I wasn’t invited to participate in consultations or do anything practical. Students who do, are very lucky.”

“Mostly negative experiences where you sit in a corner and fall asleep, however the work-life balance of General Practice is appealing.”

±- ½RH XLI EGXYEP [SVO MR +IRIVEP 4VEGXMGI VIEPP] MRXIVIWXMRK however in both my rural and metropolitan GP placements there seems to be a lot of job dissatisfaction, especially relating to the amount of time you can spend with patients who often have multiple or complex issues.”

“Depends on who you did General Practice work with. GP rotations aren’t the best indicators.” “Big variation between fantastic and bad placements.”

“I don’t like general medicine at all. I avoid medical rotations like a bad smell. I want to sub-specialise in surgery because I like the practical work and I like doing some things really well.”

“I found rural too isolating but more exciting yet urban quite routine and exhausting.” “I have seen both positives and negatives with more exposure to General Practice work.”

“The majority of presentations were not of great interest to me (e.g. depression, hypertension).”

The verbatim comments from those who indicated being either ‘Less likely’ or ‘About the same, not interested’ with regards to pursuing a career as a GP following their GP rotation, yielded responses around a few core themes; they either had a negative or uninspiring experience during their rotation, the rotation GSR½VQIH [LEX XLIMV I\TIGXEXMSRW SJ +IRIVEP 4VEGXMGI [IVI SV that the profession was not for them and/or had their mind set on another specialty. Others appeared to be deterred by the issues facing the sector that they witnessed such as the limited time GPs have to see patients. Below is a sample of these ZIVFEXMQ VIWTSRWIW

“I was initially interested due to previous experience at ERSXLIV +4 RS[ RSX WS WYVI %W E ½REP ]IEV WXYHIRX - [SYPH have expected to be given more to do then sit in the corner. I was very bored and discouraged.” “The barriers to me considering a career in General Practice are the fact that you’re a Generalist about everything but a specialist about nothing, despite some having a ‘special interest’, it isn’t really a specialty hence it’s called GENERAL Practice. The fact that GP consultations are so timed (10mins on average); I like to be very thorough and form good relationships with my patients, not an in-and-out production line. I think working in a specialty or hospital, you and your peers have more exposure to and the expectation of remaining skilled and up-to-date.”

“The GP I had a placement with was very negative about the profession - talked of powerlessness as a doctor and JIIPMRK WYTIV¾YSYW ²

'LEVX %[EVIRIWW SJ XLI %YWXVEPMER +IRIVEP 4VEGXMGI 8VEMRMRK 4VSKVEQ %+48

Q15. The Australian General Practice Training program (AGPT) is the name of the training program that GP Registrars (doctors training to become GPs) are required to complete. Were you aware of this training program prior to today? Base: All Respondents (n=1,246) 8EFPI %[EVIRIWW SJ XLI %+48 4VSKVEQ F] =IEV SJ 1IHMGEP 8VEMRMRK Awareness of AGPT Program Yes No Not Sure Total No. of Responses

Year of Medical Training Undertaking in Current Year 2nd year 3rd year 4th Year 5th Year 6th Year 59.2 % 69.5 % 80.7 % 75.6 % 84.8 % 32.8 % 23.6 % 14.3 % 15.1 % 11.1 % 8.0 % 6.9 % 5.0 % 9.3 % 4.0 % 338 259 140 86 99

1st Year 49.7 % 39.8 % 10.5 % 324

Total 64.4 % 27.7 % 7.9 % 1,246

Base: All Respondents (n=1,246) “I did 6 weeks in the remote Northern Territory where I had great autonomy. I felt I experienced a broad range of medical conditions, got involved in public health and education campaigns and felt very rewarded by the continuity of care and good doctor-patient relationships. In a metropolitan general practice, I sat in the corner for 12 weeks and occasionally measured someone’s blood pressure. Oh, and because I’m female I did pap-smear after pap-smear after pap-smear. I was very disappointed with the passive role I was forced to play and the poverty of learning opportunities when compared with the hospital environment. I don’t believe XLMW MW E VI¾IGXMSR SR +IRIVEP 4VEGXMGI TIV WI FYX E VI¾IGXMSR on the lack of government support. A bit of money invested would have meant I could see patients in my own room and my GP Supervisor, with a reduced work load, could have ACTUALLY done some teaching.”

7.1.4 Awareness of General Practice Training, Colleges and RTPs Respondents were asked a series of questions to ascertain their level of awareness with regards to the General Practice Training program and key stakeholders in General Practice training. Upon being prompted, almost two-thirds of all respondents (64%) indicated being aware of the Australian General Practice Training program prior to being surveyed, which is quite a positive result (see Chart 5 above). Breaking the results down by GPSN membership, it is encouraging to note that those who were personally involved in the GPSN (93%) followed by GPSN members (67%) were the most likely groups to be aware of the training program; amongst non-members, awareness was at just over half (59%). Î Whilst around two-thirds of GPSN members are aware of the AGPT program, ideally, all GPSN members would become aware of the program in future.

“I found that General Practice was pretty much as I expected it; lots of script writing and blood pressure and mole checking, with very little actual substance.”

It is good to note that awareness of the training program

7 | Detailed Findings

8EFPI %[EVIRIWW SJ 6IKMSREP 8VEMRMRK 4VSZMHIVW 684W RTPs Had Heard Of None

% 44.8

n 558

Adelaide to Outback General Practice Training Program Bogong Regional Training Network

12.9

161

3.4

Central & Southern Queensland Training Consortium CoastCityCountry Training General Practice Training Tasmania

5.1

4.9 7.5

61 94

General Practice Training Valley to Coast Gippsland Education & Training for General Practice GP Synergy GPlogic

4.5 5.1

56 64

7.3 4.3

91 53

Greater Green Triangle

7.8

RTPs Had Heard Of Institute of General Practice Education North Coast GP Training

% 4.2 6.4

n 52 80

Northern Territory General Practice Education Rural & Regional Queensland Consortium

12.4 6.8

154 85

Sturt Fleurieu General Practice Education & Training

6.6

Tropical Medical Training Victoria Felix Medical Education Victorian Metropolitan Alliance

10.7 2.6 3.4

133 33 42

WentWest Western Australian General Practice Education & Training

2.0 7.0

25 87

Q16. Regional Training Providers (or RTPs) deliver the Australian General Practice Training program in their designated region of Australia. Which of the following RTPs have you heard of? Please select as many as apply? Base: All Respondents (n=1,246) As shown in Table 9 above, awareness was at less than one in ten respondents for all RTPs (<10%) with the exception of Adelaide to Outback, AOGP (13%), Northern Territory General Practice Education, NTGPE (12%) and Tropical Medical Training, TMT (11%) which enjoyed the highest levels of awareness; it should be noted however that more than half of those aware of AOGP and TMT were from Adelaide and James Cook Universities respectively.

generally increases the further students are into their medical training as shown in Table 8 (page 24). Compared to that for the AGPT program, prompted awareness of the Regional Training Providers (RTPs) was a lot lower amongst medical students. Given a general, brief description of what RTPs do and provided with a list of all the RTPs in Australia, almost every second respondent (45%) admitted to not having heard of any of the RTPs listed.

As with awareness of the AGPT program, not having heard of any RTPs decreased the longer students were into their medical training as shown in Table 10 (page 26); awareness by year of medical training for the most well-known RTPs is also shown.

Those personally involved in the GPSN were by far the least likely group to have not heard of any RTPs (7%); somewhat disappointingly is that 43% of members had not heard of any whilst non-members (56%) were the most likely to have not of heard of any RTP;

As shown in Chart 6 (page 26), prompted awareness of the Royal Australian College of General Practitioners (RACGP) is at more than nine in every ten medical student (96%), an excellent result. With awareness at almost three-quarters of all students (74%), the Australian College of Rural and Remote Medicine (ACRRM), also enjoys fairly good awareness amongst medical students.

Ă&#x17D; Much work is needed to promote awareness of the various RTPs who deliver General Practice training across Australia amongst medical students, probably most particularly amongst GPSN members.

8EFPI 684 %[EVIRIWW F] =IEV SJ 1IHMGEP 8VEMRMRK % RTPs Had Heard Of None

Year of Medical Training Undertaking in Current Year 1st Year 2nd year 3rd year 4th Year 5th Year 6th Year 63.3 53.8 34.4 32.9 25.6 14.1

Adelaide to Outback General Practice Training Program (AOGP)* Northern Territory General Practice Education (NTGPE) Tropical Medical Training (TMT)*

9.6

5.0

12.0

15.0

20.9

43.4

5.9

9.5

13.9

15.7

25.6

23.2

7.7

8.9

12.7

7.9

20.9

16.2

Total 44.8 (=558) 12.9 (n=161) 12.4 (=154) 10.7 (n=133)

* It should be noted that 60% of all respondents aware of AOGP were University of Adelaide students and 66% of all respondents aware of TMT were James Cook University students. Base: All Respondents (n=1,246)

'LEVX %[EVIRIWW SJ +IRIVEP 4VEGXMGI 'SPPIKIW

Q17. There are two Colleges of General Practice in Australia that are responsible for some aspects of GP training, including setting training standards and examinations. Please indicate if you have heard of either or both of these colleges? Base: All Respondents (n=1,246)

8EFPI %[EVIRIWW SJ +IRIVEP 4VEGXMGI 'SPPIKIW F] =IEV SJ 1IHMGEP 8VEMRMRK % Aware of College RACGP ACRRM Not heard of either Total No. of Responses

Year of Medical Training Undertaking in Current Year 1st Year 2nd year 3rd year 4th Year 5th Year 86.1 97.3 100.0 99.3 98.8 68.2 69.8 81.9 74.3 80.2 7.1 2.4 0.0 0.7 1.2 324 338 259 140 86

Base: All Respondents (n=1,246)

6th Year 100.0 74.7 0.0 99

Total 95.5 73.5 2.6 1,246

7 | Detailed Findings

It is good to note that awareness of the RACGP is uniformly high amongst GPSN members and non-members alike. Awareness of ACRRM in contrast varies somewhat by group with those personally involved in the organization being by far the most likely to have heard of ACRRM (95%) followed by all other GPSN members (76%) whilst under two-thirds of nonGPSN members (61%) were aware of the College.

Provided with a description of what the GPSN is and what its objectives are, nine in every ten respondent (91%) stated having heard of the organization prior to being surveyed (see Chart 7 below). 7.2.1 Awareness of the GPSN Amongst non-members, awareness of the GPSN was at just over half (58%) (see Table 12 on page 28), however amongst those not sure if they had signed up or not, awareness was at nearly nine in every ten respondents (88%).

Looking at the awareness levels by year of medical training, (see Table 11 on page 26) RACGP enjoys high awareness across all ]IEVW XLI PS[IWX FIMRK EQSRKWX Â˝VWX ]IEVW [LMPWX XLEX JSV %'661 ZEVMIH [MXL XLI PS[IWX E[EVIRIWW EQSRKWX Â˝VWX and second years (68% and 70% respectively) and the highest amongst third years (82%).

Ă&#x17D; Just to review, the breakdown of the survey sample by +472 1IQFIVWLMT 7XEXYW [EW EW JSPPS[W Â&#x2C6; Members â&#x20AC;&#x201C; 64% Â&#x2C6; Members personally involved in the organization â&#x20AC;&#x201C; 3% Â&#x2C6; Non-members â&#x20AC;&#x201C; 14% Â&#x2C6; Not sure if signed up as a member or not â&#x20AC;&#x201C; 19%

Ă&#x17D; As with the RTPs, the results suggest a need for greater promotion of ACRRM, and likely its purpose and objectives, amongst medical students around Australia; this is of TEVXMGYPEV RIIH EQSRKWX Â˝VWX ERH WIGSRH ]IEV WXYHIRXW

It should be noted that the fairly high proportion of respondents who were not sure if they had signed up as E +472 QIQFIV TVSFEFP] VIÂžIGXW XLI LMKL TVSTSVXMSR SJ organizations or clubs that vie for medical studentsâ&#x20AC;&#x2122; attention, and thus the competition that the GPSN faces.

7.2 The General Practice Students Network (the GPSN)

The reader should also note that a greater non-member sample in future waves of the survey would enable member vs. nonmember comparisons by university, and enable analysis such as why students do/donâ&#x20AC;&#x2122;t take up GPSN membership by university.

Respondents were asked a series of direct questions in relation to the GPSN in order to begin to understand the extent to which the organization has been successful in promoting awareness of General Practice to the medical student population. 'LEVX %[EVIRIWW SJ XLI +472

Q18. The General Practice Students Network is a student organisation, which has been established to foster greater awareness of General Practice both as a lifestyle and a career choice amongst medical students. With Student Clubs in every medical school, the GPSN organises events for medical students throughout the year, ranging from academic and professional seminars, clinical workshops, career expos and other GP experience events. Before today, had you heard of the General Practice Students Network (GPSN)? Base: All Respondents (n=1,245)

8EFPI %[EVIRIWW SJ XLI +472 F] +472 1IQFIVWLMT 7XEXYW

Base: All Respondents (n=1,245) 8EFPI %[EVIRIWW SJ XLI +472 F] =IEV SJ 1IHMGEP 8VEMRMRK Aware of the GPSN Yes No Not sure Total No. of Responses

Year of Medical Training Undertaking in Current Year 2nd year 3rd year 4th Year 5th Year 6th Year 94.4% 96.9% 94.3% 96.5% 93.9% 4.5% 2.3% 5.0% 3.5% 4.0% 1.2% 0.8% 0.7% 0.0% 2.0% 337 259 140 86 99

1st Year 80.2% 16.0% 3.7% 324

Base: All Respondents (n=1,245)

Total 91.3% 7.0% 1.7% 1,245

7 | Detailed Findings

'LEVX ;LIVI -RMXMEPP] ,IEVH %FSYX XLI +472

Q19. Where did you initially hear about the General Practice Students Network (GPSN)? Base: All Respondents (n=1,245)

'LEVX %XXIRHERGI EX +472 )ZIRXW SV %GXMZMXMIW

Q21. Have you attended any events or activities organized by your local GPSN club? Base: Respondents who were GPSN members, members personally involved in the organization or who were not sure if they had signed up as a member or not (n=1,061) Amongst those who had attended at least one GPSN event, workshops (38%), lunches (35%) and GP experience events (33%) featured as some of the more popular types of events that were attended (see Chart 10 on page 31).

It is good to note that awareness of the GPSN is at high levels across all years of medical training, with the lowest being EQSRKWX ½VWX ]IEVW EW WLS[R MR 8EFPI TEKI ;LIR EWOIH EFSYX [LIR XLI] ½VWX LIEVH EFSYX XLI +472 WII Chart 8 on page 29), the most popular source was at actual events run by local GPSN clubs on campus (42%); this is a good VI¾IGXMSR SJ XLI QEVOIXMRK WYGGIWW SJ XLI +472´W GSVI EGXMZMX]

3J WSQI GSRGIVR MW XLEX SRP] SRI MR ½ZI MRHMGEXIH LEZMRK attended a career event run by the GPSN. Whilst this may FI E VI¾IGXMSR SJ XLI JEGX XLEX RSX QER] GEVIIV X]TI IZIRXW may have occurred by the time of the year this survey was conducted (end of May to early July), this result should probably be earmarked for improvement. It should also be noted that career-type information does form a component of non-career branded events such as during GP experience events when speakers talk about their training and various experiences.

The results also indicate that local GPSN Student Ambassadors (37%) and the local clubs in general (22%) are doing a good job promoting the organization to medical students around the country. 7.2.2 GPSN Events Amongst GPSN members and those respondents who were not sure if they were members, just over half (52%) recalled attending at least one GPSN event or activity organized by their local GPSN club, as shown in Chart 9 above.

Some of the events noted in ‘Other’ responses (n=21) included Launch events, a Welcome and Information Night, a short presentation in a lecture theatre and a medico-legal event. Î The running of events on university campuses is one of the main channels by which the GPSN aims to promote General Practice amongst medical students. Thus, ensuring XLEX E WYJ½GMIRX RYQFIV SJ IZIRXW EVI VYR SR GEQTYWIW to enable all interested students to attend could be a key focus moving forward. Options for attracting more students/ members to events, plus what they’d like to see offered at events could also be researched.

Î Whilst this represents a fairly good turnout, getting more members to events (perhaps at least one event a year) will probably be key for the GPSN to most effectively meet its objectives of promoting General Practice and General Practice training amongst students. Attendance to GPSN organized events or activities varied somewhat by year of medical training, from a high of 66% EQSRKWX XLMVH ]IEVW XS E PS[ SJ EQSRKWX ½VWX ]IEVW WII Table 14 on page 31).

7 | Detailed Findings

8EFPI %XXIRHERGI EX +472 )ZIRXW SV %GXMZMXMIW F] =IEV SJ 1IHMGEP 8VEMRMRK Attended GPSN-Organised Events or Activities Yes No Not sure Total No. of Responses

Year of Medical Training Undertaking in Current Year 2nd year 3rd year 4th Year 5th Year 6th Year 56.1% 66.4% 39.1% 51.4% 58.5% 34.9% 28.3% 48.7% 41.9% 31.7% 9.0% 5.3% 12.2% 6.8% 9.8% 312 226 115 74 82

1st Year 38.5% 54.4% 7.1% 252

Total 52.1% 39.9% 8.0% 1,061

Base: Respondents who were GPSN members, members personally involved in the organization or who were not sure if they had signed up as a member or not (n=1,061)

'LEVX +472 %GXMZMXMIW SV )ZIRXW %XXIRHIH SV &IIR -RZSPZIH -R

Q22. Which of the following GPSN activities or events have you attended or been involved in? Base: Respondents who were GPSN members, members personally involved in the organization or who were not sure if they had signed up as a member or not, who attended events or activities organized by their local GPSN club (n=552)

'LEVX 6IGIMZI 1SRXLP] +472 I2I[WPIXXIV

Q23. Do you receive the monthly GPSN eNewsletter? Base: Respondents who were GPSN members, members personally involved in the organization or who were not sure if they had signed up as a member or not (n=1,061) 'LEVX 6IEH 1SRXLP] +472 I2I[WPIXXIV

Q24. Do you read the monthly GPSN eNewsletter? Base: Respondents who were GPSN members, members personally involved in the organization or who were not sure if they had signed up as a member or not (n=1,061)

'LEVX 7IIR SV ,IEVH SJ +472´W 1IHMGEP 7XYHIRXW´ +YMHI %74-6)

Q26. Have you ever seen or have a copy of the medical students’ guide to General Practice put out by the GPSN called ‘ASPIRE’? Base: Respondents who were GPSN members, members personally involved in the organization or who were not sure if they had signed up as a member or not (n=1,061)

7 | Detailed Findings

with less text and the option to read more if interested (e.g. heading links to stories). Other suggestions included adding more fun content, such as jokes and prizes, having more information about General Practice such as a day in the life of a GP, information about training pathways or options, stories about young doctors or GP trainees, practical placement opportunities as well as clinical information such as that which appears in medical periodicals (e.g. â&#x20AC;&#x2DC;how to treatâ&#x20AC;&#x2122; sections).

Ă&#x17D; Ensuring that local GPSN club executives, all of whom are volunteers and full-time medical students, are well supported by GPRA in their event coordination and management will play a key role in enabling clubs to run more events on campuses; there may be a need for GPRA to explore how it can better support clubs in this regard. There may also be a need to review club structure by university (e.g. some clubs have found the need to have more than 3 club executives, others may require one club per university campus etc) to ensure that they are able to best meet the needs and demands of their respective members. Procedures on rewarding or recognizing the efforts put in by local Student Ambassadors and their teams will also be important in sustaining the network moving forward.

The 2009 edition of ASPIRE was distributed in June 2009, thus the main month during which the Student Survey was GSRHYGXIH XLMW MW PMOIP] XS LEZI FIIR MRÂžYIRGIH XS WSQI HIKVII the fact that only one in four respondents (25%) recalled having seen or heard about ASPIRE (Chart 13, page 32). Better timing between the distribution of the next edition of the publication and the conduct of the next wave of the survey should see a much greater awareness of ASPIRE in future.

7.2.3 GPSN Publications Feedback was sought from respondents with regards to the GPSNâ&#x20AC;&#x2122;s main publications, namely the monthly GPSN eNewsletter that goes out to all members and the medical studentsâ&#x20AC;&#x2122; guide produced by the GPSN annually, ASPIRE, which is distributed by local GPSN clubs to students.

Of those who had seen or had a copy of ASPIRE the majority

MRHMGEXIH Â˝RHMRK XLI MRJSVQEXMSR LIPTJYP MR XIVQW SJ MX providing useful information about General Practice and the GPSN (Chart 14, page 34). It would however be good to see E KVIEXIV TVSTSVXMSR SJ WXYHIRXW Â˝RHMRK XLI TYFPMGEXMSR ÂłZIV]Â´ helpful as opposed to just â&#x20AC;&#x2DC;quiteâ&#x20AC;&#x2122; helpful.

Taking in the responses of both members and those not sure if they were members, just under three-quarters (71%) recalled receiving the GPSN eNewsletter on a monthly basis (see Chart 11 on page 32.); not surprisingly this is highest amongst those personally involved in the organization (91%) and lowest amongst those unsure about their membership status (26%).

8LIVI MW HIÂ˝RMXIP] E KVIEX HIQERH JSV %74-6) [MXL QSVI XLER JSYV MR IZIV] Â˝ZI VIWTSRHIRX MRHMGEXMRK E HIWMVI XS receive the publication (Chart 15, page 35). Interest in the publication was high amongst all respondent groups; those personally involved in the GPSN (93%), amongst all other members (83%), as well as amongst those who were unsure if they had signed up as members or not (73%).

When asked if they actually read the GPSN eNewsletter (Chart TEKI NYWX YRHIV LEPJ MRHMGEXIH MR XLI EJÂ˝VQEXMZI which is not a bad result for an eNewsletter. As with recall, actual readership of the eNewsletter was highest amongst those personally involved in the GPSN (77%). In contrast readership was at just over half (57%) of all other members.

7.2.4 Overall Effectiveness of the GPSN Respondents were asked to rate the extent to which they agreed with a series of statements about the GPSN as a means of gauging the degree to which the GPSN is meeting its core objectives (see Table 15 on page 35).

Respondents were also asked for any suggestions they may have had for improving the eNewsletter. Of those who MRHMGEXIH VIEHMRK XLI I2I[WPIXXIV EVSYRH SRI MR Â˝ZI provided a suggestion.

Whilst more than half of the respondents (which included members, those personally involved in the GPSN and those unsure if they were members) agreed that the organization has

A review of respondentsâ&#x20AC;&#x2122; suggestions indicated that many would like to see the eNewsletter made more brief or concise

'LEVX ,IPTJYPRIWW SJ %74-6) MR 4VSZMHMRK 9WIJYP -RJSVQEXMSR SR +IRIVEP 4VEGXMGI XLI +472

Q27. How helpful have you found the information in ASPIRE, in terms of it providing useful information about General Practice and the GPSN? Base: Respondents who were GPSN members, members personally involved in the organization and those who were not sure if they had signed up as a member or not and who recalled having seen or had a copy of ASPIRE (n=262) 'LEVX -RXIVIWX MR 6IGIMZMRK %74-6)

Q28. Would you like to receive the 2009 edition of ASPIRE? Base: Respondents who were GPSN members, members personally involved in the organization or who were not sure if they had signed up as a member or not (n=1,061) provided information about General Practice training pathways and insights into the opportunities available in General Practice (56% and 57% agreement respectively), only around one in ten ‘strongly agreed’ that this was the case. This would suggest that whilst the GPSN has been effectively promoting these aspects of General Practice, further work will be needed for it to be seen as a strong source of this information, particularly amongst its members.

proportions also agreed, that the GPSN had provided them with opportunities to attend clinical workshops (44%) and opportunities to network with other medical students (46%) – with those personally involved in the organization, again the most likely to agree these opportunities are provided. The area that looks to require the greatest amount of attention would be providing students with the opportunity to network with GPs and stakeholders in the GP sector, with only around a third of all respondents (31%) agreeing that the GPSN has been effective in this regard.

Similarly, whilst almost one in two (48%) agreed that the GPSN has provided them with opportunities to hear talks or presentations from established GPs on their professional and personal experiences, relatively few (17%) felt strongly about this – those personally involved in the GPSN were the most likely to say they ‘strongly agreed’ (54%). Similar

It should be noted that ‘don’t know’ responses for each statement amongst respondents unsure if they were members, ranged from 36% to 41%.

7 | Detailed Findings

8EFPI )JJIGXMZIRIWW SJ XLI +472 MR 4VSQSXMRK %[EVIRIWW SJ +IRIVEP 4VEGXMGI +IRIVEP 4VEGXMGI 8VEMRMRK

Q29. We would like to get an idea of how successful the GPSN has been in promoting awareness of General Practice and General Practice training. Please rate the extent to which you agree that the GPSN has provided you with the following opportunities? Base: Respondents who were GPSN members, members personally involved in the organization or who were not sure if they had signed up as a member or not (n=1,061) one in three respondents (30%) indicated that the GPSN has successfully inspired them to consider General Practice which is a very positive result (see Chart 17, page 37).

In all, 44% of respondents could say that they felt that they had gained a better understanding of what’s involved in becoming a GP since joining the GPSN (see Chart 16, page 36). When the responses of those who were unsure if they had signed as members were removed, this proportion increased to 53% (as shown in Table 16 on page 36) which is a great result for the organization and testament to its effectiveness in promoting General Practice.

When the responses of those who were unsure if they had signed as members were removed, this proportion increased to 34% (as shown in Table 17, page 37); of note is that just 22% of respondents indicated that they’ve always wanted to be a GP which indicates that the organization is not just attracting students who are already pre-disposed to the General Practice specialty.

The fairly high proportion of members who indicated not being able to give a response (23% , see Table 16 on page 36) perhaps VI¾IGXW XLEX XLI] VIUYMVI QSVI STTSVXYRMXMIW XS KIX MRZSPZIH with the GPSN or to attend GPSN events; as suggested in a previous sub-section, ensuring that enough GPSN events are run on university campuses may be key to achieving this.

Furthermore the fact that 15% of members indicated they still don’t want to be a GP despite their being members, indicates that the GPSN is also attracting students who are not necessarily keen on pursuing a career in General Practice but perhaps are still keen in understanding what General Practice involves; another good result for the GPSN.

The overall effectiveness of the GPSN was also measured by asking respondents how likely they now are to consider General Practice as a career since joining the GPSN. Just under

'LEVX ,EZI E &IXXIV 9RHIVWXERHMRK SJ ;LEX +4W (S 7MRGI .SMRMRK XLI +472

Q30. Do you feel you’ve gained a better understanding of what’s involved in becoming a GP since joining the GPSN? Base: Respondents who were GPSN members, members personally involved in the organization or who were not sure if they had signed up as a member or not (n=1,061) 8EFPI ,EZI E &IXXIV 9RHIVWXERHMRK SJ ;LEX +4W (S F] +472 1IQFIVWLMT 7XEXYW

Base: Respondents who were GPSN members or members personally involved in the organization (n=834)

7 | Detailed Findings

'LEVX 0MOIPMLSSH SJ 'SRWMHIVMRK +IRIVEP 4VEGXMGI EW E 'EVIIV 7MRGI .SMRMRK XLI +472

Q31. Would you say you are more likely to consider General Practice as a career since joining the GPSN? Base: Respondents who were GPSN members, members personally involved in the organization or who were not sure if they had signed up as a member or not (n=1,061) 8EFPI 0MOIPMLSSH SJ 'SRWMHIVMRK +IRIVEP 4VEGXMGI EW E 'EVIIV F] +472 1IQFIVWLMT 7XEXYW

Base: Respondents who were GPSN members or members personally involved in the organization (n=834)

Appendices

Appendix A – Survey Questionnaire 1. General Practice Students Network (GPSN) Survey We would like to invite you to complete a short survey on the GPSN and your perceptions of General Practice. 8LI WYVZI] [MPP SRP] XEOI QMRYXIW XS GSQTPIXI ERH F] IRXIVMRK ]SY GER KS MRXS E HVE[ XS [MR SRI SJ ½ZI 'SPIW 1]IV Gift Vouchers. The survey is being conducted by the GPSN to help us understand how Australian medical students feel about General Practice as a specialty and a career choice. All medical students studying in Australia are being invited to take part in the survey. For more information about the GPSN or this survey please email us at gpsn.enquiries@gpra.org.au 1. Just to start with, we’d like to ask you a few questions about you... What year of your medical training are you undertaking this year? { 1st year medical school { 2nd year medical school

{ 3rd year medical school { 4th year medical school

{ 5th year medical school { 6th year medical school

Other (please specify) _______________________________ 2. At which University are you studying? Other (please specify) _______________________________ 3. Are you currently undertaking your pre-clinical or clinical studies? { Pre-clinical { Clinical 4. Please indicate which of the following (if any) is your current preferred career choice. First Choice

Second Choice

Third Choice

Anaesthetics

{

Emergency Medicine

{

General Practice

{

Surgery

{

Medicine (i.e. Hospital Medicine)

{

Obstetrics & Gynaecology

{

Paediatrics

{

Pathology

{

Psychiatry

{

Radiology

{

8 | Appendices

First Choice

Second Choice

Third Choice

Research

{

I am currently undecided

{

Other (please specify) _______________________________ 2. Perceptions About General Practice 5. How would you rate your overall attitude towards General Practice as a career choice? { Very positive { Mostly positive { Neither positive nor negative { Mostly negative { Very negative { Don’t’ know/Can’t say 6. Can you tell us why you gave the above rating? ________________________________________________________________________________________ 7. ;I´H PMOI XS KIX ER MHIE SJ [LEX ]SY ORS[ EFSYX +IRIVEP 4VEGXMGI *VSQ [LEX ]SY YRHIVWXERH Yes

Don’t know/Not sure

Is General Practice a specialty in its own right?

{

Does General Practice require further training after internship/residency?

{

8. 4PIEWI VEXI XLI I\XIRX XS [LMGL ]SY EKVII [MXL IEGL SJ XLI JSPPS[MRK WXEXIQIRXW EFSYX +IRIVEP 4VEGXMGI Neither Agree Don’t nor Strongly know/ Disagree Disagree Disagree Not sure

Strongly Agree

Agree

General Practice plays an important role in the longterm healthcare of patients

{

You can enjoy the continuity of care with patients in General Practice that is lacking in other specialties

{

General Practice is just as challenging as other specialties

{

As a GP, you can enjoy a healthy work-life balance

{

General Practice offers the opportunity to pursue diverse special interests during training and practice

{

Neither Agree Don’t nor Strongly know/ Disagree Disagree Disagree Not sure

Strongly Agree

Agree

You can earn a sufficient income while training and working as a GP

{

General Practice is central to delivering quality healthcare in Australia

{

4PIEWI TVSZMHI ER] EHHMXMSREP GSQQIRXW LIVI CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC 9. We’re interested to hear about what factors have shaped your perceptions about General Practice as a career choice. You may have heard things about General Practice from other people. For each of the following, can you please rate what their ZMI[W EFSYX +IRIVEP 4VEGXMGI LEZI FIIR PMOI

Mostly positive

Mostly negative

Neither Positive nor Negative

N/A

Other medical students

{

Friends outside of medical school

{

University teaching staff

{

Doctors who are not in General Practice

{

Family member(s)

{

Hospital staff

{

Interns

{

GP Registrars

{

Medical mentor(s)

{

Your own GP

{

4PIEWI TVSZMHI ER] EHHMXMSREP GSQQIRXW LIVI CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC 10. Have you started or completed a GP rotation or placement as part of your training yet? { No, I have not started or completed a GP rotation { Yes, I have started or completed a GP rotation

8 | Appendices

3. Experience With Rotations 11. If you have completed a GP rotation, in which demographic was it done? { Metropolitan { Rural or Remote { I have completed both a metropolitan and a rural or remote rotation { I have not yet completed my rotation 12. ,S[ [SYPH ]SY VEXI ]SYV +4 VSXEXMSR I\TIVMIRGI SZIVEPP# 4PIEWI RSXI MJ ]SY LEZI GSQTPIXIH QSVI XLER SRI +4 VSXEXMSR TPIEWI TVSZMHI ER SZIVEPP VEXMRK { Mostly positive { Mostly negative { Not positive or negative { Not sure { Not applicable 13. Since completing your GP rotation(s), would you say you are now more likely or less likely to pursue a career as a GP? { More likely { Less likely { About the same, not interested { About the same, still interested in being a GP { Donâ&#x20AC;&#x2122;t know { Not applicable 14. Can you tell us why you gave the above answer? ________________________________________________________________________________________ 4. About GP Training 15. The Australian General Practice Training program (AGPT) is the name of the training program that GP Registrars (doctors training to become GPs) are required to complete. Were you aware of this training program prior to today? { Yes { No { Not sure

16. Regional Training Providers (or RTPs) deliver the Australian General Practice Training program in their designated region of Australia. Which of the following RTPs have you heard of? Please select as many as apply. NONE Adelaide to Outback General Practice Training Program Bogong Regional Training Network Central & Southern Queensland Training Consortium CoastCityCountry Training General Practice Training Tasmania General Practice Training Valley to Coast

Gippsland Education & Training for General Practice GP Synergy GPlogic Greater Green Triangle Institute of General Practice Education North Coast GP Training Northern Territory General Practice Education Rural & Regional Queensland Consortium

Sturt Fleurieu General Practice Education & Training Tropical Medical Training Victoria Felix Medical Education Victorian Metropolitan Alliance WentWest Western Australian General Practice Education & Training

17. There are two Colleges of General Practice in Australia that are responsible for some aspects of GP training, including setting training standards and examinations. 4PIEWI MRHMGEXI MJ ]SY LEZI LIEVH SJ IMXLIV SV FSXL SJ XLIWI GSPPIKIW Royal Australian College of General Practitioners (RACGP) Australian College of Rural and Remote Medicine (ACRRM) Have not heard of either 5. About GPSN 18. The General Practice Students Network is a student organisation, which has been established to foster greater awareness of General Practice both as a lifestyle and a career choice amongst medical students. With Student Clubs in every medical school, the GPSN organises events for medical students throughout the year, ranging from academic and professional seminars, clinical workshops, career expos and other GP experience events. Before today, had you heard of the General Practice Students Network (GPSN)? { Yes { No { Not sure

8 | Appendices

19. Where did you initially hear about the General Practice Students Network (GPSN)? My local GPSN Student Ambassador My local GPSN club Other student(s) Stall at orientation week

Event at my university (e.g., workshop, seminar, lunch etc) Lecture announcement Facebook Internet search engine

Word of mouth Posters University email/timetable Not Applicable

Other (please specify) _______________________________ 20. Are you a GPSN member? { Yes, I’m a member { Yes, I’m a member and personally involved in the organisation { No, I’m not a member { Maybe - not sure if I’ve signed up as a member or not 6. GPSN Members 21. Have you attended any events or activities organized by your local GPSN club? { Yes { No { Not sure 22. Which of the following GPSN activities or events have you attended or been involved in?

Lunch Orientation week event (e.g., stall) Workshop (e.g., clinical, suture, plastering workshop) GP Experience Event (e.g., seminar) Career event

Other (please specify) _______________________________ 23. Do you receive the monthly GPSN eNewsletter? { Yes { No { Not sure 24. Do you read the monthly GPSN eNewsletter? { Yes { No { Not applicable

Cocktail evening event GPSN Schwartz First Wave Scholarship Program Breathing NEWLIFE into General Practice Conference Not Applicable

25. Do you have any suggestions for what you would like to see in the GPSN eNewsletter or how you think it could be improved? 4PIEWI X]TI MR ER] WYKKIWXMSRW FIPS[ _______________________________________________________________________________________ 26. Have you ever seen or have a copy of the medical students’ guide to General Practice put out by the GPSN called ‘ASPIRE’? { Yes { No 27. How helpful have you found the information in ASPIRE, in terms of it providing useful information about General Practice and the GPSN? { Very helpful { Quite helpful { Not helpful { Don’t know { Not applicable 28. Would you like to receive the 2009 edition of ASPIRE? { Yes { No 29. We would like to get an idea of how successful the GPSN has been in promoting awareness of General Practice and General Practice training. 4PIEWI VEXI XLI I\XIRX XS [LMGL ]SY EKVII XLEX XLI +472 LEW TVSZMHIH ]SY [MXL XLI JSPPS[MRK STTSVXYRMXMIW Neither Agree nor Strongly Disagree Disagree Disagree

Don’t know/ Not sure

Strongly Agree

Agree

Information about the General Practice training pathways

{

Insights into the array of opportunities available through a career in General Practice

{

Talks or presentations from established GPs about their professional and personal experiences

{

Opportunities to attend clinical workshops (e.g. suturing, plastering)

{

Opportunities to network with other medical students

{

Opportunities to network with GPs and stakeholders in the GP sector

{

4PIEWI TVSZMHI ER] EHHMXMSREP GSQQIRXW LIVI CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC

8 | Appendices

30. Do you feel you’ve gained a better understanding of what’s involved in becoming a GP since joining the GPSN? { Yes { No { Don’t know/Can’t say 31. Would you say you are more likely to consider General Practice as a career since joining the GPSN? { Yes, more likely { No - no change, I always wanted to be a GP { No - no change, I still don’t want to be a GP { No - I’m now less likely to become a GP { Don’t know/Can’t say 32. (Optional) If you are interested in knowing more about General Practice Training please provide your email address so that we can send you more information – please note, your email address will be used to send you information and will not be used JSV ER] SXLIV TYVTSWI __________________________________________________________________________________ 7. Notification for Winning 33. Thank you for your responses. We just have a few more questions about you so that we can understand how different people have responded to the survey. What is your gender? { Male

{ Female

34. And what age group are you in? { Under 18 { 18 – 24

{ 25 – 30 { 31 – 40

{ 41 – 50 { Over 50

35. Do you identify yourself as Aboriginal or Torres-Strait Islander? { Yes { No 36. Which of the following best describes your household situation? { Single { Single with child/children { In a relationship but not living together

{ Married or Defacto { Married or Defacto with child/children

37. (Optional) If you’re not a GPSN member, please let us know if you’d like to sign up. { Yes { No { Already a member

8LEX [EW SYV PEWX UYIWXMSR 8LERO ]SY JSV ½PPMRK SYX XLMW WYVZI] =SYV JIIHFEGO [MPP FI MRZEPYEFPI MR WLETMRK JYXYVI +472 MRMXMEXMZIW -R SVHIV XS KS MRXS XLI TVMÎ HVE[ XS [MR SRI SJ ½ZI 'SPIW 1]IV :SYGLIVW TPIEWI IRXIV ]SYV IQEMP EHHVIWW FIPS[ ]SYV email address will only be used to contact you in case you are a winner). One winner will be drawn every Friday for the next 5 weeks (commencing Friday 5 June, with the last draw on Friday 3 July). All [MRRIVW [MPP FI RSXM½IH F] IQEMP 4PIEWI WII FIPS[ JSV JYVXLIV HIXEMPW SR XLI TVMÎ HVE[W Thank You & Good Luck! Your e-mail address _______________________________________________________ Prize Draw Details: All prize draws will be drawn randomly and take place at General Practice Registrars Australia (GPRA) at Level 1, 14 Queens 6SEH 1IPFSYVRI :MGXSVME SR IEGL SJ XLI JSPPS[MRK HEXIW XL .YRI XL .YRI XL .YRI XL .YRI ERH VH .YP] EX TQ ;MRRIVW [MPP FI RSXM½IH F] IQEMP ERH XLIMV REQIW TVMRXIH MR XLI +472 I2I[WPIXXIV -J ER] TVMÎ MW RSX GPEMQIH [MXLMR [IIOW SJ RSXM½GEXMSR RI[ [MRRIVW [MPP FI HVE[R Entries are limited to one (1) per person. Only medical students currently enrolled in a medical course in Australia are eligible to complete the survey and enter the prize draw.

8 | Appendices

Appendix B – Overall Attitude Towards General Practice as a Career Verbatim Responses

“I like the concept that rural GPing requires independence in practice and broad up-skilling, but I worry that there may be a lack of support (especially for junior doctors) when it’s required. Being a suburban GP seems boring and doesn’t appear to hold the same challenges as remote GPing, so is not very appealing to me.”

Q6. Can you tell us why gave the above rating (initial question being, Q5. How would you rate your overall attitude towards General Practice as a career choice?)

7EQTPI SJ XLI R! ZIVFEXMQ VIWTSRWIW TVSZMHIH Respondents who rated their overall attitude towards General Practice as a Career Choice as ‘Very Positive´

“It allows you to have a broad range of exposure to different aspects of medicine and I think there is a lot more continuity of care in a GP setting.”

It’s a good lifestyle, shorter training program, more opportunity to focus on an area of interest (e.g. sporting injuries, OG, sexual health).

“I grew up in a country town and was exposed to amazingly skilled GPs whom I aspired to be like. I love the variety and GLEPPIRKI SJ +IRIVEP 4VEGXMGI MR EHHMXMSR XS MXW ¾I\MFMPMX] ²

:IV] MQTSVXERX NSF M I XLI ½VWX TSMRX SJ GSRXEGX [MXL LIEPXL care for many people.

“Comments from GPs themselves or older medical students have given a positive view on the better quality lifestyle you can have as a GP as well as the different areas you can focus your interests on.”

±- FIPMIZI MX [SYPH FI E JYP½PPMRK GEVIIV ERH EQ I\XVIQIP] interested in it, but at this stage in my studies, I have not had enough clinical exposure to it.” “Over the past few months my perceptions towards General Practice as a career has been changing. I began medicine convinced I did not want to be a GP, but after attending GPSN information nights and clinical placements I’m appreciating positives such as patient relationships, diversity of presenting cases etc. However I chose ‘mostly positive’ because I really have no idea what my ultimate career choice will be.”

Respondents who rated their overall attitude towards General Practice as a Career Choice as ‘Mostly Positive´ “I really enjoyed a recent GP placement, so I feel a lot more positive towards General Practice. I have heard that as a female GP particularly, half of what you do is pap smears... I do realise that this is an exaggeration, however it would MR¾YIRGI Q] HIGMWMSR XS FIGSQI E +4 ²

“Well I love General Practice - but it lacks procedural work. Becoming a rural Generalist enables me to be a GP with additional procedural skills.”

“I enjoy the variety of medicine seen in General Practice, however, - ½RH XLEX XLI EGYXI QIHMGMRI TVIWIRX MR LSWTMXEP QIHMGMRI MW missing. Ideally, I would like a mixture of these two.”

“I wouldn’t like to become a GP at the moment, but I can see myself becoming one when I’m older and don’t feel like working in a hospital.”

“I think it would be a rewarding job - you would be able to meet a great variety of people and illnesses. The hours would not be unreasonable and you would be able to have great patient-doctor relationships.”

±-R E VYVEP WIXXMRK +IRIVEP 4VEGXMGI GER FI E ZIV] HMJ½GYPX career path as there is not much support and you could be the only GP in a single town, this is a little stressful and worrying! However it is a very diverse career path which interests me.”

“I like the idea of diversity, working outside the hospital system and getting to know my patients. I don’t like the idea SJ HIEPMRK [MXL PS[ PIZIP LIEPXL TVSFPIQW PMOI GSPHW ¾YW ²

“Favourable lifestyle, ability to work own hours, ability to sub-specialise, relatively short post-graduate study program. However possible lack of variety and procedural work.”

“I believe that GPs play a crucial role providing the front line medical care for the majority of the population. However I think that I may become bored as a GP because a large role is to manage chronic diseases rather than manage acute life threatening problems.”

“GPs receive less respect than physicians and surgeons from their colleagues and from patients. GPs have infrequent access to collaborative continuing education with colleagues.” “I think in certain environments General Practice could be a very rewarding career choice. Getting to know and treat families in a small, independent practice over a long period SJ XMQI [SYPH FI VIEPP] WEXMWJ]MRK MJ RSX XLI QSWX ½RERGMEPP] rewarding career. Working in a massive medical centre with loads of locums you don’t know, churning through patients you will never see again, would be my idea of hell.”

“Life as a GP would be easier; seeing patients with more common problems and referring to others if more serious.” ±1EMRP] ERIGHSXEP FYX TSWMXMZIW MRGPYHI ¾I\MFMPMX] MR [SVO hours, easy access into training programs, lifestyle. Negatives MRGPYHI MRXIPPIGXYEP GLEPPIRKI MR TEVXMGYPEV ½IPHW SJ MRXIVIWX and pay (with regards to amount of work vs. pay received).”

Respondents who rated their overall attitude towards General Practice as a Career Choice as ‘Neither Positive nor Negative´

“On the whole I have found my GP placements interesting and rewarding, though I have heard General Practitioners complain about the amount of red tape they encounter in day to day practice.”

“I haven’t had much exposure to clinical practice yet hence can’t make a judgment.” “At the moment, I am not very aware of exactly what a GP does, so I feel that I cannot form an opinion.”

“General Practice would be my fourth preference at the moment. I’m ‘mostly positive’ because I think it would be E JYP½PPMRK NSF [MXL EGGITXEFPI ZEVMIX] TEXMIRX GSRXEGX ERH lower stress than other specialties. It isn’t ‘very positive’ due to possible lack of challenge and opportunities.”

“It has its pros and cons. While I would love the hours and patient contact, the lack of use of skills I have learned...and challenging procedures/cases I think would get boring...and make doing 4 years of medicine seem almost like a waste.”

±-X WIIQW XS FI E ZIV] ¾I\MFPI GEVIIV [MXL KVIEX PMJIWX]PI Also a good choice for women with child-bearing age.”

“Not sure I want to sit in a tiny room pumping patients XLVSYKL IZIV] QMRYXIW ERH HIEPMRK [MXL ¾Y ERH IPIZEXIH BP and depression all day every day in an urban GP practice - boring!”

±+IRIVEP 4VEGXMGI SJJIVW ¾I\MFMPMX] SJ LSYVW ERH EFMPMX] XS FI a person with an ‘in-demand’ job anywhere in the world. My only hesitations are the sheer breadth of knowledge GPs are responsible for and not earning as much as other specialists.”

8 | Appendices

“Neutral to the idea, because I am not sure I like the General Practice setting and work. I would like to be in a more dynamic environment of the hospital.”

“Is a good solid career however the scope seems a little small. Such that it seems there isn’t quite a lot of variety compared to other specialties.”

Respondents who rated their overall attitude towards General Practice as a Career Choice as ‘Mostly Negative´

“Not enough incentive to be a GP; you’re over-worked. Also less ability to be a small business owner in the current environment. In the past most GPs owned their own practice, but now GPs are fast becoming employees of businesses who happen to own a GP practice.”

“We keep getting told that it’s so good that ‘all of us’ want XS FIGSQI ³VYVEP +4W´ )WTIGMEPP] FIMRK MR XLI ½VWX GSLSVX there was apparently that expectation which truthfully turned me off General Practice somewhat.”

“I have been motivated for hospital practice, so have never really considered General Practice.” “I can think of pros and cons but overall there are more suitable options ahead of General Practice on my list. General Practice sounds isolating – less teamwork and interaction with fellow professionals. A lot of aspects of patient care that are not particularly ‘medical’.” “Enjoy the variety, challenges and patient interaction. On the other hand, many city GPs seem to dislike aspects of their jobs, e.g. bureaucracy, red tape, the whinging well, etc.”

“I am a New Zealand citizen and have to do the 10 year moratorium. If I choose GP, I have to work in a rural or remote area for 10 years otherwise I do not have a provider number.”

“From talking to GPs I’ve done experience with it sounds as if they do a lot of hard work for a small salary compared to other specialties.”

±8LI GEVIIV SJ +IRIVEP 4VEGXMGI WIIQW PMQMXIH ERH GSR½RIH to a normal boring day job compared to the hospital environment for most junior medical students.”

“Managing chronic diseases and forwarding interesting patients onto other people doesn’t interest me.”

“I entered medical school with the intention of going into General Practice. I was attracted to the variety and continuity of care available. However, my experience as a medical student was rather negative. We had 18 weeks in General Practice. I spent 6 of these in a remote Aboriginal community which was a fantastic experience. I had great EYXSRSQ] EW [IPP EW WYJ½GMIRX WYTIVZMWMSR ERH QIRXSVWLMT My exposure to metropolitan General Practice however, was very different. There were not enough rooms or time for me to see patients on my own. I largely spent 12 weeks sat in a corner ‘observing’. Passive learning such as this will never attract students to General Practice.”

“I see it as ‘less exciting’ and perhaps a career choice in the later stages of my career... would suit the family lifestyle.” “Huge time constraints on care delivery; has become largely a referral service; long hours seeing many patients for relatively poor remuneration.” “Didn’t particularly enjoy my placement last year; mainly dealt with alcohol abuse, depression and diabetes. It was depressing in itself and quite boring.” “From what I have seen on clinical placements in General Practice (particularly rural general practice) GP’s work extremely long hours. Also, I have seen that in many

“Seems like a highly stressful job that isn’t adequately remunerated for the effort required.”

practices GPs don’t have the time to take a detailed history or perform a proper examination on many of their patients which decreases the quality of care and also decreases XLI GLERGIW SJ ½RHMRK STTSVXYRMXMIW XS MQTVSZI TEXMIRX outcomes with preventative medicine. In addition to this, most GP’s have said that their income is poor compared with their work demands. Most GP’s I have been on clinical placements with in metropolitan and rural Australia have expressed dissatisfaction with their work.”

“I do not like the job scope of a GP, especially the continuing care aspect.” “I have felt that General Practice is being run into the ground. All of the GPs that I have been placed with have been fantastic doctors, but I think the system, the community and their peers underrate them. The intrusion of Medicare and increasing paperwork and the paternalistic approach of other avenues of medicine to General Practice do not encourage me to take it up as a specialty.”

“Does not particularly suit my personality. I prefer procedural/surgical modalities of work.” “Time-pressured, under-valued, HUGE responsibility. Sitting in the same spot talking to people all day.” “I’ve talked to GPs about wages and $300k a year max just doesn’t cut it. I would like to earn $550k+ P.A.” ±- ½RH XLI [SVO HYPP QE]FI FIMRK E QIHMGEP WXYHIRX WMXXMRK MR XLI GSVRIV SJ E +4´W SJ½GI JSV LVW E HE] JSV [IIOW bored to distraction, probably didn’t help.” “10 years working in the rural for international student doesn’t seem appealing.” “Seen by others as the easy way out, not a choice but something to settle for.” “I feel that there are more ‘rewarding’ careers out there in XLI QIHMGEP ½IPH [LIVI ]SY GER LEZI E QSVI WMKRM½GERX impact on patients.” Respondents who rated their overall attitude towards General Practice as a Career Choice as ‘Very Negative´ “Too much promotion and exposure to GP has turned me off it. It’s all we ever hear about and we get sick of it.” “I don’t care for sitting at a desk all day listening to neurotic mothers who bring in their child with a runny nose and think they are dying and listening to people’s problems in general.” “From own experience with General Practitioners and also family JVMIRHW XLEX EVI +IRIVEP 4VEGXMXMSRIVW %PWS - ½RH XLI [SVO XLEX GP’s do (from minimal exposure) to be rather boring.”

GENERAL PRACTICE STUDENTS NETWORK

Email: gpsn.enquiries@gpra.org.au Fax: (03) 9820 1983 Mail: PO Box 7292, St Kilda Rd, Melbourne 8004