More than Money 2013 by GPRA Publications

More than Money A negotiation guide for GP registrars

Secure your win-win employment agreement The future of general practice

Your registrar services team are here to help.

About this guide

“Make every bargain clear and plain, that none may afterwards complain.” Greek proverb

For many general practice registrars, negotiating an employment agreement can be a challenging process. The 2013 More than Money – A negotiation guide for GP registrars is designed to help make contract negotiation easier for you throughout your training and post-fellowship. It contains guidelines that apply to both registrars and general practitioners at any career stage, however, in particular it contains the terms and conditions for GPT1 and GPT2 registrars.

• Have you got questions about your employment agreement? • Want to know how to get the most out of your GP training? • Want access to exam preparation resources? • Want to connect with people who have gained fellowship? • Want help managing stress or other personal matters? • Need information on tax and financial planning, investing or buying a practice? Contact us for support and information web: gpra.org.au email: registrarenquiries@gpra.org.au phone: 03 9629 8878 GPRA280213388

There are many things to consider when making the transition from the hospital-based system to general practice. Hospitals have highly standardised terms and conditions of employment, whereas private general practice - being a business - has more flexibility. There is scope to negotiate the terms and

conditions of your employment agreement based on the value you bring to the practice. At the end of the negotiating process with each practice, you should have a signed written agreement that both parties have agreed to and understood. This will go a long way towards preventing any possible misunderstandings later on. With an agreement in place, you will be free to enjoy your time at the practice as you develop your competency and career as a GP. Good luck! The GPRA Registrar Services team

This publication is also available online at gpra.org.au or call GPRA on 03 9629 8878. ©2013 GPRA. All rights are reserved. All materials contained in this publication are protected by Australian copyright law and may not be reproduced, distributed, transmitted, displayed, published or broadcast without the prior permission of General Practice Registrars Australia Ltd (GPRA) or in the case of third party material, the owner of that content. You may not alter or remove any trademark, copyright or other notice from copies of the publication. No part of this publication may be reproduced without prior permission and full acknowledgement of the source: More than Money, A negotiation guide for GP registrars, a publication of General Practice Registrars Australia. All efforts have been made to ensure that material presented in this publication was correct at time of printing and published in good faith. However, GPRA takes no responsibility for any change to any information provided by or sourced from outside agencies and referred to in this publication.

The future of general practice

Contents

Definitions used in this guide

About this guide

Definitions used in this guide

Your essential negotiating checklist

Let’s get negotiating

Why should I negotiate an employment agreement?

Limitations of the NMTC

Negotiate your employment agreement in seven easy steps

Elements to consider before negotiating

The employment conditions in detail

What do other registrars earn and negotiate?

The GPRA Terms and Conditions Benchmarking Survey Expectations

26 30

The supervisor/registrar relationship

Maximising your income as a registrar

Troubleshooting

Ready to sign?

Resources 37 Help GPRA Appendix. National Minimum Terms and Conditions for GPT 1 and GPT 2 registrars - 2013 and 2014 training year

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37 38

Aboriginal Medical Service (AMS): A community controlled health organisation featuring extended appointment lengths and a focus on Aboriginal health. Australian College of Rural and Remote Medicine (ACRRM): One of the two general practice colleges. ACRRM has a curriculum of educational objectives for rural GPs and a fellowship process for vocational registration. Australian General Practice Training (AGPT): The training program for GP registrars. Australian Medical Association (AMA): An independent organisation that represents the professional interests of all doctors, including political, legal and industrial interests. College/s: Refers to the RACGP and/or ACRRM. General Practice Education and Training (GPET): A government limited company that funds and contracts regional training providers to provide general practice education to registrars and prevocational doctors. General Practice Registrars Australia (GPRA): Represents GP registrar issues to the Department of Health and Ageing, GPET, ACRRM, RACGP and other bodies involved in general practice training; promotes general practice as the medical specialty of choice to medical students and prevocational doctors; and provides support to GP registrars.

GPT1, GPT2, GPT3: Six month general practice terms 1, 2 and 3. The National General Practice Supervisors Association (NGPSA): The GPRA equivalent for supervisors. It undertakes an advocacy role for supervisors, particularly in terms and conditions negotiations. National Minimum Terms and Conditions (NMTC): The agreed to minimum terms and conditions of employment for GPT1 and GPT2 for the 2013 and 2014 training year. Practice: The training general practice employing the registrar. Practice Incentives Program (PIP): The Medicare Australia Practice Incentives Program aimed at improving access and health outcomes for patients. RA classification: Australian Standard Geographical Classification-Remoteness Area (ASGC-RA). The Australian Bureau of Statistics model whereby all cities and towns in Australia are assigned a number between RA 1-5. This is used to calculate incentive payments to doctors outside metropolitan areas: RA1 - major cities; RA2 - inner regional; RA3 - outer regional; RA4 – remote; RA5 very remote. Regional training provider (RTP): An organisation created to deliver education and training within a specific geographical region.

More than money – an initiative of GPRA

Definitions used in this guide continued â&#x20AC;Ś

Your essential negotiating checklist

Registrar: The general practice registrar on the AGPT program.

This negotiating checklist is a summary of key topics that may be covered and documented in your employment agreement.

Registrar liaison officer (RLO): A registrar employed by a regional training provider to represent and advocate for GP registrars and liaise with GRPA.

Working hours

The Royal Australian College of General Practitioners (RACGP): One of the two general practice colleges. The RACGP offers a fellowship for vocational registration (FRACGP) and a fellowship in Advanced Rural General Practice (FARGP).

Leave

Hours, sessions and locations, educational release time, administration time

Annual leave

Training and employment load

Compassionate leave

On-call, after-hours and additional ordinary hours

Study leave

Number of patients per hour

Education and supervision

Personal/carers leave (includes sick leave)

Parental leave

Other matters Medical indemnity insurance

Service Incentive Payment (SIP): The Medicare Australia service incentive payment.

In-practice teaching Educational release time

Personal safety and occupational health and safety

Supervisor: A general practitioner accredited to supervise general practice registrars.

Supervision

Fatigue management

Remuneration

Restrictive covenants

Base salary or percentage of billings plus superannuation

Renegotiation

Pay for ordinary hours

Termination of employment

Pay for off-site work including hospital VMO, nursing home and home visits Pay for after-hours and on-call work On-call percentage - on premises and off premises

Dispute resolution

Contract paperwork Complete your written agreement and ensure it is signed and dated by you and your employer

Frequency of billing and payment cycles Payment for working on public holidays Payment for leave SIPs and PIPs payments Any accommodation subsidies Any other allowances and expenses 4

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More than money â&#x20AC;&#x201C; an initiative of GPRA

Let’s get negotiating

Why should I negotiate an employment agreement? General Practice Registrars Australia (GPRA) negotiates the National Minimum Terms and Conditions (NMTC) agreement with the National General Practice Supervisors Association (NGPSA) on behalf of GPT1 and GPT2 registrars. The NMTC can be found in the Appendix at the end of this guide or online at gpra.org.au While the NMTC agreement is a great starting point, it is a goodwill document and doesn’t act as a contract on its own. You need to have a signed employment agreement that incorporates the NMTC. It is strongly recommended that you sign an employment agreement with your practice that clearly sets out all the elements of your employment.

Use the GPRA employment agreement template available for download at gpra.org.au

Owning a written employment agreement between you and your practice ensures clarity between the employee and employer, and gives both parties recourse against breaches under contract law. The negotiation process is important in developing a shared understanding of what has been agreed to.

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Remember, the NMTC is a statement of the ‘minimum’ terms and conditions and, as a GPT1 and GPT2 registrar, you may be offered or may be able to negotiate terms that are better than this minimum. Conflicts between registrars and practices usually arise because of confusion over what has been agreed to, rather than as a result of deliberate breaches. It is therefore best to be clear about all aspects of your employment agreement from the outset to avoid any potential problems in the future. Any verbal agreements about your terms and conditions need to be confirmed in your employment agreement in order to be legally binding. The NMTC may not be applicable to all registrars in all situations. For example, registrars in GPT3 and beyond, and registrars working in an Aboriginal Medical Service or similar environments with non-standard appointment lengths, are not covered by the NMTC. However, this publication remains a useful guide to help you understand what can, and should be, negotiated. We encourage you to enter the negotiation process with an attitude of goodwill and a willingness to look for a win-win outcome. Remember, negotiation is a two-way street.

Who will I be negotiating with? It is important to have some understanding of the business structure of a practice. Increasingly, it is individuals other than your supervisor who have control over the running of the business or negotiating employment agreements. The main point-of-contact in a practice will usually be your supervisor, practice owner or practice manager. Depending on the business structure, you may typically be negotiating with one or more of the following people: • Supervisor – training issues • Receptionist – work times and days • Practice manager – work times, days and financial matters such as billing, billing cycles, superannuation • Business manager – financial matters (as above) • Corporate officer – financial matters (as above).

Limitations of the NMTC Employment in an Aboriginal Medical Service or other community controlled health organisation is often significantly different to standard private practice. For example, training and employment in an Aboriginal Medical Service often includes additional release-time to engage with the community, and the standard appointment length may be different to private practice.

Therefore, the fee-for-service (percentage of billings) model cannot be applied successfully in these types of workplaces. In community controlled health organisations, the NMTC agreement does not apply. Therefore you will need to negotiate your own salary and conditions no matter what term you are in. To do this, you may wish to refer to the 2012 GPRA Terms and Conditions Benchmarking Survey to see what other registrars in the training program earn. You should negotiate similar arrangements to registrars with similar experience, using a salaried model. Additionally, you may be eligible for incomefriendly salary packaging or salary sacrificing while working for a not-for-profit organisation. Ask your employer what benefits, if any, apply to you. See what other registrars in the training program are earning by viewing the 2012 Terms and Conditions Benchmarking Survey at gpra.org.au Please contact the GPRA Registrars Services team if you have any questions at registrarenquiries@gpra.org.au

More than money – an initiative of GPRA

Let’s get negotiating continued …

Employee versus contractor Some GP registrars and practices believe there are advantages to registrars working as contractors rather than employees of the practice. The NSGPA, GPRA and regional training providers (RTPs) have all considered this matter and strongly recommend that practices should engage GP registrars as employees, and not as independent contractors. The legal advice obtained by these organisations indicates that under the law, the relationship between a training practice and a GP registrar is that of an employer and employee. Considering both industrial relations law and taxation law, this relationship would not be recognised as that of a principal and independent contractor. Even if payment arrangements are set up on the basis of contracting, this arrangement would be considered invalid and would be deemed to be that of an employer and employee if the matter came before a Court of law. This applies to all terms undertaken by GP registrars. GPRA believes that registrars are more likely to be disadvantaged financially by working as a contractor, and practices run a legal risk if a registrar is a contractor.

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For information on the difference between a contractor and an employee, it is recommended that registrars and practices refer to the definitions outlined on the Australian Taxation Office (ATO) website ato. gov.au Involvement in an apprenticeship or trainee situation has a significant impact on whether an individual is viewed by the ATO as a contractor or an employee. In rare cases you may be eligible to work as a contractor. However, we strongly urge that you seek independent legal and taxation advice to ensure you meet all the necessary requirements. View the NMTC in the Appendix at the end of this guide or visit gpra.org.au for further information.

Negotiate your employment agreement in seven easy steps 1. Read, research and prepare. Prior to your employment interview, read this guide. You should also become familiar with the NMTC in the Appendix at the end of this guide or online at gpra.org.au 2. Find an employment agreement template. Some RTPs have a standard employment agreement template, so ask whether yours does. GPRA has an employment agreement template available for download and use at gpra.org.au 3. Think about what you want to negotiate on before your interview. Consider what’s really important to you and areas where you may be willing to compromise. Aim high, but know the least you are prepared to walk away with.

6. Staple a copy of your completed agreement to a copy of your letter of appointment and the NMTC. Once the paperwork is completed and signed, ensure that both you and the practice keep a copy. 7. Relax and enjoy your general practice term. Once you know everything is properly documented, you’ll be free to enjoy your work at the practice!

GPRA has an employment agreement template available for download and use at gpra.org.au

4. Bring copies of the employment agreement template, the ‘Essential negotiating checklist’ on page 5 of this guide, and the NMTC to your interview. Record the outcomes of the negotiated topics on your agreement template. 5. Ask for time before you sign. This time allows you to read and understand the agreement. If you are unsure about any aspect seek clarification - there are no dumb questions! Consult your registrar liaison officer (RLO) or GPRA if you are unsure about any aspect of your agreement before you sign. More than money – an initiative of GPRA

Elements to consider before negotiating

The needs of individual registrars are unique. The needs of practices also differ. While reading this guide, think about which elements in the agreement are the most important to you and which ones you could accept a compromise on.

Working hours

Being able to compromise on one or more elements that are not vital to you, but helpful to the practice, can put you in a stronger negotiating position overall. Unless you understand some of the issues that are critical to the practice, you will find it difficult to build a positive, long-term working relationship.

The details of the structure of your average working week should include start and finish times, scheduled consulting hours (including home, hospital and nursing home visits), locations, time allocations for administration, in-practice teaching, educational release and any on-call and after-hours duties.

It is wise to think about the bigger picture during negotiations. Earning a reasonable income is necessary for most of us, but there are considerations beyond money. Your years as a registrar are, essentially, a learning experience.

This is a very important discussion you need to have with the practice. Ensure the results of this discussion are documented in your employment agreement.

There are many other aspects that should be kept in mind when negotiating an employment agreement. These may include the availability of training in the areas that interest you, a willingness by the practice to fit in with the days you want to work, and the ethos and values of the practice and its staff. These will differ from registrar to registrar, but finding a practice that suits you is important to your wellbeing.

There are five main areas that you should discuss with the practice when negotiating your employment agreement. These should be considered each term, from GPT1 and beyond.

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Think about your personal life, family, friends and hobbies. Is there anything that will be happening during the term that you need to advise the practice of? For example, leave, a medical procedure, major events, exams?

How many hours are you planning to work each week? This will impact on the category of your training and employment (this is discussed further in Section 2).

The number of patients per hour GPT1 registrars may start with 2-3 patients per hour and increase up to the maximum for GPT1 and GPT2 registrars of four patients per hour (as specified in the NMTC). Sometimes the patient mix can determine the number of patients per hour. For example, if you are the only female doctor in a busy practice, you may get a particular patient mix which impacts on the total number of patients you can see. This is something to keep in mind and to discuss with your practice.

Education and supervision Familiarise yourself with the Australian College of Rural and Remote Medicine (ACRRM) and/ or The Royal Australian College of General Practitioners (RACGP) training standards that apply to you.

potential issues that may arise, and to try and ensure that your learning needs will be met ahead of time.

In-practice teaching It is important to discuss the nature of your in-practice teaching with your supervisor prior to starting work at your practice. Where possible, document this discussion to ensure there is mutual agreement and understanding on how and when your in-practice teaching will occur. In-practice teaching can take many forms, such as tutorials with supervisors or others in the practice, supervised procedures, practice educational meetings and corridor teaching. A useful tip is to schedule dedicated teaching first thing in the morning or after lunch to ensure that your time is not compromised by patient consultations running late.

What are your areas of interest? Your RTP supports your formal training with an individual learning plan, guidance and monitoring by medical education staff and GP supervisors in a practice environment. Keep in mind your medical areas of interest and those of the practice and your supervisor. It is important to define in your learning plan your areas of interest up front and determine how the people and skill-sets within the practice can help you meet your personal learning goals. Talk to the practice about your learning plan so that you can identify any

The GPRA In-practice teaching resource can be found on the GPRA website atgpra.org.au/publications. The resource, written in consultation with GP supervisors and medical educators, provides clear direction as to how registrars can take ownership of their own learning to ensure they meet their individual learning needs and in-practice teaching standards.

More than money â&#x20AC;&#x201C; an initiative of GPRA

Elements to consider before negotiating continued …

Educational release Find out what your mandatory and optional educational release commitments are. Check with your RTP at the beginning of each term. The amount of educational release tends to reduce each term as you progress through the training program. Your practice is not obligated to fund extra or optional educational workshops run by your RTP beyond the minimum requirements.

Your supervisor’s obligations The employer must provide supervision that meets Australian General Practice Training (AGPT) guidelines. Mutually agreed supervision must be available at all times including for after-hours and on-call work. The supervisor or a delegated replacement should be available to attend in-person to support the registrar in the event of an emergency, except in circumstances approved by the colleges.

clarified with your employer and documented in the employment agreement. Higher incomes become possible when a registrar’s billings for the practice exceed the NMTC minimum wage. Typically, the transition point comes when you are seeing an average of three patients per hour in eight or more sessions per week. Other factors also contribute, such as whether the practice bulkbills or charges higher private patient rates. Registrars in GPT3 or beyond who work in a private practice are usually able to negotiate market rates and are typically paid a percentage of their billings. This percentage would normally be higher than the GPT2 rate specified in the NMTC. Beyond GPT3, you must still be an employee of the practice. It is still important to ensure that you have an employment agreement. The NMTC and the GPRA employment agreement is a great place to start.

Financial incentives – PIP and SIPs The Practice Incentive Program (PIP) and Service Incentive Payments (SIPs) are financial incentives paid by Medicare Australia to achieve certain national health outcomes. Many registrars are unclear about whether they, or the practice, should receive these payments. PIP payments are paid to the practice. Except for the anaesthetic PIP and obstetric PIP, individual GPs and GP registrars do not receive PIP payments. SIPs are usually paid to the individual GP or GP registrar performing the service. However, it is common for the payment to be shared between the registrar and the GP or practice if, for example, the GP supported the registrar or specialised equipment was required to deliver the service. Details of PIP payments and SIPs should be written into your employment agreement.

Subsidies, equipment and expenses

Consult your RLO or GPRA if you are unsure about any aspect of your employment agreement before you sign.

Remuneration The basis on which you will be paid According to the NMTC, registrars should be paid the minimum base salary or a percentage of billings, whichever is greater. This should be 12

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Calculate your potential income online The GPRA online earnings calculator is helpful in estimating your potential income based on billings. Visit gpra.org.au

Rural or remote placements may include accommodation or rental subsidies. Discuss with your RTP what you may be eligible to receive. Your employment package may also include travel allowances or reimbursement for certain expenses. These are outside the NMTC and may be negotiated on a case-by-case basis.

Equipment: Will you need to provide any of your own equipment? (Stethoscope, auroscope/ophthalmoscope, ear thermometer, neuro exam kit, doctor’s bag, reference books.) Will you be travelling in your personal vehicle to visit patients?

Leave Your leave entitlements and scheduling As an employee, you are entitled to leave arrangements as set out under the Fair Work Act and the National Employment Standards. This includes annual leave, personal/carer’s leave (including sick leave), compassionate leave, study leave and parental leave. These are non-negotiable and the practice must offer the legislated minimum leave, just like any other business. If you would like to take leave during your training, it is wise to discuss this with your supervisor or relevant practice staff member as early as possible, especially if the leave you require falls during a busy period for the practice. All employees must receive entitlements as set out under the Fair Work Act including superannuation and annual leave.

More than money – an initiative of GPRA

Elements to consider before negotiating continued …

The employment conditions in detail

Study leave

Working hours

There is no automatic entitlement to study leave, however, some practices may allow you to take unpaid leave to prepare for exams. You should negotiate this with your practice as soon as you are aware you are sitting exams.

Parental leave Parental leave requirements are dealt with according to the Fair Work Act and the National Employment Standards. Registrars may be eligible for payments via the federally funded parental leave scheme. For more information, visit familyassist.gov.au General Practice Education and Training (GPET) allows for parental leave (without pay) in the Australian General Practice Training (AGPT) program. Contact your RTP or refer to gpet.com.au for further information.

Other talking points The following points are unlikely to be core issues in your employment agreement, but are common questions that may arise when you start at a new practice. Orientation Will the practice conduct an orientation session? Consulting room Will I share a room or have my own room?

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Bulk-billing versus private billing What is the bulk-billing versus private billing mix? Which patients are bulk-billed? Appointment booking system What is the practice appointment booking system? Booked appointments versus walk-ins and emergencies? What about home, hospital and nursing home visits? Follow up of test results What is the normal procedure for following up patients’ test results at the practice? What happens with test results that come in after I’ve left the practice? Registrar as educator teaching obligations Will I be doing in-practice teaching of medical students or others? Is this paid? When will this be required and how often? This section discusses the specific employment terms and conditions that should be covered in the negotiation process. It allows you to easily follow the order of the NMTC and the GPRA employment agreement template. To get the most out of this section, follow this order in your employment agreement. Refer to the Appendix at the end of this guide for the NMTC or visit gpra.org.au The GPRA employment agreement template can also be found at gpra.org.au

Reference: NMTC sections 4 and 5 The NMTC defines ordinary hours as the time between starting and finishing work each day between 8 am and 8 pm Monday to Friday and 8 am and 1 pm Saturday. Meal breaks and on-call time are not included in ordinary hours. Ordinary hours include: a) normal general practice activities including: – scheduled consulting time – home, hospital and nursing home visits – administrative time b) practice based teaching time c) educational release time. Ensure your ordinary hours are agreed on prior to the start of the term. Your ordinary hours should be itemised and detailed in your employment agreement.

Full-time versus part-time Before negotiating your employment agreement be sure that you are clear on your training and employment load. Full-time employment is defined as 38 hours per week, averaged over a four-week cycle with no less than 27 hours per week averaged over four weeks of patient contact time. A full-time salary is based on a 38-hour week.

• Full-time training is determined by ACRRM and the RACGP. ACRRM defines full-time training as 38 or more hours per week including any administration and educational activities. The RACGP defines full-time training as nine sessions or more per week with sessions averaging 3.5 hours. • Part-time employment is any number of hours less than 38 hours per week averaged over a four-week cycle. A parttime salary is pro-rata based on a 38 hour week. Ordinary hours for a part-time registrar are no less than 10.5 hours per week averaged over four weeks, with no less than nine hours per week of patient contact time and worked over no less than two days per week. • Part-time training is based on the number of hours less than those specified by the respective colleges (ACRRM and RACGP) of patient face-to-face time. ACRRM defines part-time training as less than 38 hours per week including any administration and educational activities. The RACGP counts part-time as being eight sessions or less per week with sessions averaging 3.5 hours. Training and employment are separate considerations when it comes to full-time and part-time definitions.

• Full-time equivalent (FTE) is a workforce calculation detailing a working load compared to a 38-hour week. More than money – an initiative of GPRA

The employment conditions in detail continued …

Example: A registrar works a total of 31.5 hours per week (9 x 3.5 hour sessions) at the practice. They are considered a part-time employee of the practice, however they may be considered to be training on a full-time basis, depending on their training pathway. Educational releases typically do not occur every week, and depending on your RTP, you may attend these weekly, fortnightly or monthly. Educational release varies from RTP to RTP, and may be face-to-face or online, and during or after business hours. Overall, educational release time can be averaged over a relevant time period. This is useful for when you are doing more consulting in certain weeks and more formal education at other times.

On-call and after-hours Reference: NMTC section 5 The NMTC states that where a practice is normally open outside of ordinary hours, the registrar may be rostered to work. The registrar may also be rostered to be on-call. These hours are considered a normal part of general practice. The NMTC requires that the working arrangements for registrars should be no more onerous than for other GPs at the practice. This means that you should be working similar weekend hours to the other supervisors, GPs and registrars at your practice. If the GPs in your practice usually work afterhours, then there may be an expectation for you to also contribute. You should ensure that these expectations are explicit in your employment agreement, and that you are comfortable with these expectations.

It is important to ensure that both you and your practice are aware of the educational release requirements from your RTP, and that these are factored into your employment agreement.

If working after hours is not something you can commit to due to personal reasons, this should be discussed and must be explicitly included in your employment agreement.

Part-time hours and conditions apply on a pro-rata basis. The exception to this is teaching and educational release. This is calculated at half that of full-time registrars, irrespective of the hours worked.

When discussing rosters and working hours it is important to recognise the importance of reasonable registrar rostering taking into consideration commuting requirements between workplaces (including educational releases).

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It is also important to consider your personal wellbeing and fatigue management. Ask the practice if they have policies on personal safety and fatigue management (Reference: NMTC section 5.3 and 17). These policies should be referred to in your employment agreement.

Read the GPRA Fatigue Management in Vocational General Practice Training document at gpra.org.au

Additional ‘ordinary hours’ are not generally listed in your employment agreement, but may arise during the year. Additional ordinary hours may be worked by the registrar by negotiation with the practice. For example, a part-time registrar may be asked to fill in for a colleague who needs a couple of days off. Where this occurs during regular hours, it is not considered overtime, and no overtime is payable on those hours. However, registrars may decline practice requests to work additional ordinary hours without penalty or disadvantage.

According to the NMTC there is no overtime rates payable on additional ordinary hours and so the pay rates for ordinary hours applies.

Education and supervision Reference: ACRRM and RACGP training standards

The nature of your in-practice teaching Reference: NMTC section 5 Your employment agreement should include the times, dates and any other details about your in-practice teaching where possible. A useful tip is to schedule dedicated teaching first thing in the morning or after lunch to ensure that your time is not compromised by patient consultations running late. Full-time registrars are entitled to three hours per week in GPT1 and two hours per week in GPT2 of in-practice teaching (or half the full-time allocation for part-time registrars). One hour of this teaching time is required to be protected, contiguous, face-to-face teaching time. Different supervisors and registrars have a variety of teaching styles and learning styles. We encourage that this is discussed and mutually agreed – and times agreed in advance. GPRA has a great in-practice teaching guide to help maximise your in-practice teaching experience. Visit gpra.org.au

More than money – an initiative of GPRA

The employment conditions in detail continued …

Educational release time

Remuneration

Reference: NMTC section 5

According to the NMTC agreement, registrars should be paid the minimum base salary or a percentage of billings, whichever is greater. This should be clarified with your employer and documented in your employment agreement.

Full-time registrars are entitled to be released from the practice for paid educational release time of 3.5 hours per week in GPT1 and 3.5 hours per fortnight in GPT2. With some RTPs you are also entitled to educational release in later terms. The minimum required educational release time should be funded by your practice and this should be included in your employment agreement. Educational release is paid at the registrars base rate. Part-time registrars are entitled to educational release equal to half of the time allocated to full-time registrars, irrespective of the hours they work. As a part-time registrar, you can choose to attend more sessions in your own time, or attend only half of the educational release sessions. Some RTPs may mandate this for registrars and this should be discussed with the RTP rather than with the practice. Some RTPs run extra educational workshops beyond the minimum requirements. Your practice is not obliged to fund this time.

Your supervisor’s obligations Reference: NMTC section 6 Your employment agreement should include details of your supervision and teaching arrangements, including who the supervisor is, their contact details, and the supervision and teaching time arrangements. Your employment agreement should also stipulate the details of ordinary and after-hours working arrangements. 18

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Refer to the 2013 GPRA Terms and Conditions Benchmarking Survey in Section 3 or online at gpra.org.au to see what other registrars are earning.

Minimum salary for GPT1 and GPT2 registrars

2013 training year minimum salary for GPT1 and GPT2

Weekly salary

Until 30/06/2013

01/07/2013 to 30/06/2014

GPT1 or equivalent

$72,620

$1,399.23

9.00%

9.25%

GPT2 or equivalent

$87,476

$1,682.23

9.0%

9.25%

Payment by billings for GPT1 and GPT2

Reference: NMTC section 7 The minimum annual salary for a full-time registrar is set out in the NMTC in addition to the statutory rate of superannuation. For GPT1 and GPT2, most practices will use the minimum rates set out in the NMTC as a base salary rate.

A higher income becomes possible when a registrar’s billings for the practice exceed the NMTC minimum wage. A higher percentage of billings rate also makes a substantial difference to income. Although the NMTC sets the minimum percentage of billings plus the statutory rate of superannuation for GPT1 and GPT2, some registrars are on 50% of billings or more. This may be negotiable, and having more experience or special skills are good reasons to negotiate for a higher rate.

The minimum annual salary is reviewed yearly in accordance with Medicare Australia and the AMA. These are minimum rates only and higher rates can be negotiated, especially by registrars in GPT3 or above.

Rate of superannuation

Annual salary

Reference: NMTC section 7

The statutory rate of superannuation is to be paid at the rate set by the Commonwealth Government. From 1 July 2013, superannuation contribution rates will change year-to-year and will affect all employees. The rates can be found in the NMTC or by visiting the Australian Taxation Office website at ato.gov.au

Rate of superannuation

From

Bear in mind that it is unreasonable to be paid a higher percentage of billings than very experienced GPs working in the same practice as you. Gross billings include all the fees you will generate working at the practice. SIPs are included in gross billings on receipt. The registrar is not entitled to PIP payments with the exception of the anaesthetic PIP and obstetric PIP. The agreed SIPs and PIPs arrangements should be included in your employment agreement.

Percentage of billings

Rate of superannuation

03/06/2013

45.00%

9.00%

01/07/2013

30/06/2014

44.90%

9.25%

01/07/2014

30/06/2015

44.79%

9.50%

More than money – an initiative of GPRA

The employment conditions in detail continued …

Calculate your income online. If you would like a rough estimate of what your income might be based on billings, use GPRA’s online earnings calculator at gpra.org.au

Pay for overtime Reference: NMTC section 7.2 Overtime can be taken as time off in lieu at the ordinary pay rate, hour for hour, within one month of accrual. Alternatively, overtime can be paid at 150% of the ordinary rate plus the statutory rate of superannuation. Discuss which arrangement will apply to you and ensure it is specified in your employment agreement.

Pay for after-hours and on-call work Reference: NMTC section 7.3 According to the NMTC, after-hours and on-call work is paid at a minimum of 55% of gross billings plus the statutory rate of superannuation. This applies whether the work is undertaken at the practice or off-site. If this includes hospital-based work, in addition to the 55% of billings, registrars should also receive 55% of any on-call allowances paid by rural hospitals plus the statutory rate of superannuation.

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Frequency of billing and payment cycles Reference: NMTC section 7.4 This is a very important discussion point for GP registrars. Clarity on when and how often you are paid can minimise any issues that can later cause tension between the practice and registrar. Registrars should be paid at least fortnightly. This may be the salary or billing percentage (whichever is greater). In a small number of cases, registrars are paid the minimum salary with a ‘top-up’ each month, or every three months if their billing percentage was greater. GPRA’s recommendation is that registrars are paid on a fortnightly basis and their billings be compared to the base salary, and if greater, paid at the same time. It is important to clarify when your billings will be calculated and paid in comparison to the minimum salary in your employment agreement. The NMTC billing cycle is three months (13 weeks), and NGPSA and GPRA agree that it should never be longer than this period of time. GPRA’s 2010 Terms and Conditions Benchmarking Survey shows that fewer than 13% of registrars were on a 13-week billing cycle. If you are negotiating for a weekly or fortnightly billing cycle and the practice wants to use a 13-week billing cycle, it may be useful to advise them that over 80% of registrars are on a billing cycle shorter than 13 weeks.

Many practice staff have mentioned that it is also easier to calculate and pay on a more regular basis when billings are regularly higher than the minimum salary. As per Section 14 of the NMTC, practices should pass on billing information to registrars regularly, and at no less a rate than other doctors in the same practice. Most GP billing software gives an up-to-date calculation; you may like to request access to this calculation so you can check it at any time.

GPRA highly recommends registrars understand and confirm billing and pay cycles in their employment agreement prior to beginning employment.

Leave According to the NMTC, leave is paid at the minimum annual salary rate: • GPT1: $1399.23/38 hours = $36.82 per hour • GPT2: $1682.23/38 hours = $44.27 per hour. Leave entitlements are accrued over time. If you are working part-time you may want to use the Fair Work Ombudsman leave calculator to assist in determining your leave entitlements. Visit fairwork.gov.au

Annual leave Reference: NMTC section 7.1

Renegotiation Reference: NMTC section 7 GPRA recommends that you set a date to review your employment agreement and remuneration and pay cycles after three months. There may be the opportunity to negotiate a better deal if you have been performing well. It’s also a good chance to revisit any elements of the agreement that may not be working.

Registrars are entitled to two weeks paid annual leave every six months, or four weeks per year. The number of hours of leave accrued is based on your standard hours of work. On termination of employment, an employer must pay an employee for any untaken annual leave that has accrued.

If you like the practice, ask about long-term job prospects. Many practices will be looking for registrars to permanently join their team. So if you fit in well, this may be an opportunity to discuss future opportunities. More than money – an initiative of GPRA

The employment conditions in detail continued …

Example: A full-time registrar working 38 hours per week will accrue 76 hours leave (ie. 10 days) after 26 weeks employment. A part-time registrar working 20 hours per will accrue 40 hours leave after 26 weeks employment.

Personal/carers leave Reference: NMTC section 7.2 Personal/carer’s leave is leave taken due to personal illness or injury (sick leave) or to provide care to an immediate family or household member who requires care or support due to personal illness or injury or an unexpected emergency (carer’s leave). Personal/carer’s leave for a full-time registrar is accrued on the basis of 1/26 of the number of ordinary hours worked during the previous completed four-week period.

Example: A full-time registrar working 38 hours per week will accrue 38 hours personal/carer’s leave (ie. 5 days) over a 26 week term. A part-time registrar working 20 hours per week will accrue 20 hours personal/ carer’s leave (ie. 2.5 days) over a 26-week term.

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Study leave Reference: NMTC section 7.6 There is no automatic entitlement to study leave. Some practices may allow you to take unpaid leave to prepare for exams. Include any details of your negotiated study leave arrangements in your employment agreement.

Expenses and subsidies You may be entitled to travel allowances or reimbursement of certain expenses. These fall outside of the NMTC and can be negotiated on a case-by-case basis. Be sure to document these in your employment agreement.

Travel expenses

The accommodation subsidy shall be distributed appropriately to either the registrar or the practice, depending on who incurs the cost of provision of accommodation. This should be stipulated in your employment agreement. If a registrar is undertaking a GP term in a rural area, the practice will support the registrar in accordance with RTP terms and conditions. This includes assisting the registrar to find accommodation to suit their needs (which is self-contained, fully-furnished and includes kitchen facilities) and is in accordance with the standard approved by GPET. The registrar will be responsible for payment of gas, electricity and private telephone usage.

Medical registration and indemnity insurance Reference: NMTC section 13.1 and 13.2 As a registrar, you must hold an appropriate level of medical indemnity insurance for the work you will need to carry out. You must also have current registration with the Medical Board of Australia. Your prospective employer is entitled to ask for evidence of this. GPRA suggests that details of your medical registration and indemnity insurance are documented in your employment agreement. The practice will ensure it has insurance to cover workers’ compensation for the registrar. You must inform the practice immediately if:

Reference: NMTC section 11.1 Travel expenses should be discussed. Reimbursement rates are paid at the standard rates available from the Australian Taxation Office.

Relocation expenses

Rural or remote placements may include accommodation or rental subsidies. Talk to your RTP to see what you might be eligible to receive.

Reference: NMTC section 11.2 Unless otherwise agreed, practices are under no obligation to meet a registrar’s relocation expenses. Registrars should check if they are eligible for relocation subsidies from their RTP.

Accommodation support details Reference: NMTC section 12 GPRA and NGPSA agree that neither the practice nor the registrar should be financially disadvantaged in supporting a registrar’s accommodation.

Financial incentives – PIP and SIPs

• your medical registration is withdrawn or conditions are imposed on it

• your medical indemnity insurance changes or is terminated for any reason.

Reference: NMTC section 13.7 The exact portion of SIPs the registrar is to receive should be included in your employment agreement. Incentive payments are included in the registrar’s gross billings, however registrars and the practice may wish to negotiate a higher rate. More than money – an initiative of GPRA

The employment conditions in detail continued …

Termination of employment Reference: NMTC section 15 Employment should not be terminated by the registrar or practice before the completion of the term other than in exceptional circumstances. There should be extensive discussion between the practice, GP supervisor, registrar and RTP before such action is taken. Termination notice periods should be discussed and stated in the employment agreement and both parties should adhere to these. Exceptional circumstances where patient or doctor safety is at risk or extenuating personal circumstances may allow for termination without any notice by either party. This should be discussed and legal advice sought as appropriate. Any accrued entitlements must be paid to the registrar following termination of employment.

Geographic restrictions on future employment Reference: NMTC section 16 Restrictive covenants that ban a doctor from practising in the future within a certain geographic range from the employer’s practice are designed to protect the practice’s client base.

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GPRA has obtained preliminary legal advice to indicate that restrictive covenants are unlikely to stand up to scrutiny for registrars in the training program, as registrars typically don’t control their placements and are often required to move practices to meet their training requirements. However, there is no case law on this issue. To get a firm ruling, this issue would need to be tested in a Court of law. GPRA believes that restrictive covenants have no place in a training program and would be very difficult to uphold within the training context. Registrar placements should always be driven by the registrar’s learning plan and their training needs. To protect registrars from any unnecessary legal costs, GPRA strongly recommends that registrars should not agree to any restrictive covenants. If a practice is insisting that such a clause should be included, think about approaching your RTP or GPRA for support.

Personal safety Reference: NMTC section 17 It is the practice’s responsibility to provide a safe working environment for registrars. As employers, practices are liable if they fail to provide such an environment, regardless of intent. Similarly, it is the duty of registrars as employees to raise any occupational health and safety (OH&S) issues that they become aware of, and to comply with the existing OH&S policy of the practice. The practice will ensure it has insurance to cover workers’ compensation for the registrar. GPRA strongly encourages early and transparent discussions on any issues related to personal safety. We also encourage that these discussions should be entered into in good will and with a genuine regard to safety, not to push other agendas. Ask the practice of any practice policies that you need to be aware of and make reference to them in your employment agreement.

Include references to any relevant practice policies in your employment agreement.

If there is any threat to personal safety this must be raised and discussed immediately and, where possible, put in writing. Depending on the severity of the risk, the registrar may choose not to work until the issue is resolved, or the practice and registrar may agree to an action plan and timeline to resolve the issue.

Dispute resolution Reference: NMTC section 18 Disputes rarely occur. Should a dispute arise between you and your practice over the terms and conditions of your employment, you should inform your RTP immediately. Each RTP has its own process of dispute resolution. Registrars may also seek advice about resolving the dispute from GPRA. The NMTC states that during the dispute resolution process, both parties should endeavour to continue working in an appropriate and professional manner. It is a good idea to agree to a dispute resolution process and timeframes as part of your employment agreement. This should include issues such as serving a written notice of dispute by either party, and agreeing to a mediation process by nominating the RTP or appropriate individual or organisation as a go-to point when there is a dispute. Having a clear process can often hasten the resolution process and provide win-win outcomes.

More than money – an initiative of GPRA

What do other registrars earn and negotiate?

The GPRA Terms and Conditions Benchmarking Survey

Table A: Average weekly and sessional earnings (see page 27)

In 2012, GPRA conducted the bi-annual Terms and Conditions Benchmarking Survey to benchmark the salaries and employment conditions of GP registrars currently working in the Australian General Practice Training (AGPT) program. There were 501 responses from registrars at all stages of training. This survey will be conducted again mid-2014 and results published online at gpra.org.au

The earning per session average increases according to the experience of the registrar and how rurally located their practice is. Males earn slightly more per session than females ($316.29 vs $284.27).

In such a diverse environment as general practice, it is often hard to know how the deal you are being offered measures up to the experiences of others. The findings of this survey can help give you an idea. But remember, everyone is different and a ‘good deal’ is one that you are happy with.

GPRA’s 2012 Terms and Conditions Benchmarking Survey can be found in full at gpra.org.au

As would be expected, registrars with more experience have better employment arrangements and conditions than those in their earlier years of training. The earning average of a full-time GP registrar in Australia is $291 per session, while earning potential increases from $229 per session in GPT1 to $345 in GPT3. 26

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Table A: Average weekly and sessional earnings n

Per session ($)

Per week ($)

Overall average

445

291.10

2,166

FRACGP term GP Term 1

179

229.55

1,835

For general practice work, most registrars are paid according to the NMTC agreement (62.3%) with a surprising number of GPT3 registrars still using the NMTC (50.4%).

GP Term 2

265.99

1,746

GP Term 3

130

345.18

2,546

Extended skills (ie. GPT4)

371.67

2,430

Table B: How registrars’ pay is calculated

Region RA1*

136

282.89

1,995

The majority of GPT1 and GPT2 registrars (75.5%) are paid less than 49% of billings, whereas registrars in GPT3 and GPT4 are paid generally over 50%, with one-third paid 55-59% of billings.

RA2*

182

294.27

2,256

RA3*

290.02

2,174

RA4*

364.97

2,946

RA5*

350.00

1,750

Table C: Percentage of billings earned according to day worked and general practice term (see page 28)

Gender Male

106

316.29

2,584

Female

324

284.27

2,043

Furthermore, the majority of those who are paid a percentage of billings (81.9%) are on a weekly, fortnightly or monthly billing cycle rather than the default three-month cycle. This is a plus for these registrars, because a longer billing cycle can decrease earnings, especially when calculating leave pay. A shorter billing cycle – preferably weekly or fortnightly – can work in a registrar’s favour.

Country graduated Australia

295

295.11

2,165

Another country

134

287.93

2,196

(see page 28)

* Australian Standard Geographical Classification-Remoteness Areas (ASGC-RA). RA1 - major cities; RA2 - inner regional; RA3 - outer regional; RA4 – remote; RA5 - very remote

More than money – an initiative of GPRA

What do other registrars earn and negotiate? continued …

Table B: How registrars’ pay is calculated Fixed salary

Table D: Frequency of billing cycle % billings

NMTC

Overall total

6.5%

25.1%

62.3%

GP Term 1

6.2%

10.1%

80.3%

GP Term 2

8.7%

10.9%

73.9%

GP Term 3

6.9%

40.5%

50.4%

Extended skills

5.0%

57.5%

35.0%

Table C: Percentage of billings earned according to day worked and general practice term <49%

50-54%

55-59%

>60%

Ordinary GPT1/2

75.5%

13.0%

3.5%

2.0%

GPT3/4

13.0%

27.2%

33.3%

25.3%

Saturday GPT1/2

47.7%

13.6%

9.1%

5.3%

GPT3/4

9.1%

23.1%

33.0%

28.9%

Sunday GPT1/2

12.3%

3.5%

22.8%

8.8%

GPT3/4

10.5%

14.0%

26.3%

41.1%

After hours GPT1/2

11.4%

4.3%

18.6%

20.0%

GPT3/4

14.3%

7.9%

19.0%

47.6%

Weekly

13.0%

Fortnightly

56.3%

Monthly

12.6%

3-monthly

12.8%

On average, registrars work 7.4 sessions each week with males working an additional session per week compared to females (8.2 vs 7.1 sessions). Overall, it appears that registrars are generally well informed as to their entitlements, with 86.4% reporting that they had read the NMTC agreement prior to signing their contract. There was significant confusion around what types of leave registrars are entitled to, with

24.5% of respondents unsure if they were able to take study leave, and 48.2% unsure about maternity/paternity leave. Additionally, only 75.6% of registrars indicated they were entitled to paid annual leave. The survey appears to indicate that breaches of the NMTC occur among employers of GP registrars and this is of great concern to GPRA. Specifically, there are some registrars who are working as contractors (12.0%). Also, many registrars indicated not being able to take the mandatory sick leave (4.1%) and annual leave (3.6%) to which they are entitled. A further 11.9% did not have a signed paper contract with their current employer. The survey results suggest that registrars as a whole need assistance with the employment agreement negotiation process.

Note: that not all rows total 100% as ‘don’t know’ responses are not included

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More than money – an initiative of GPRA

Expectations

The supervisor/registrar relationship

Fairness

Essential items to consider

There are three key elements that supervisors want in a negotiation with a prospective registrar: enthusiasm, simplicity and fairness. These are probably what registrars also want.

Remember that every time you negotiate a benefit for you it costs the practice: look at the effects on both parties. Also remember the sole income the practice generates is from patient fees. When you’re not seeing patients, the practice is still paying the overheads and is unlikely to want to pay extra (eg. leave loading, holiday pay) for those periods you are not earning a fee for the practice. Expect a lesser percentage if you want to negotiate these elements into your employment agreement.

All registrars must be employees. This means that practices must pay PAYE tax on wages and pay the superannuation guarantee levy. This protects both registrars and supervisors for indemnity and Workcover purposes. You can have a ‘contract of employment’, but you must still be an employee, not a contractor, until you have completed your training.

The supervisor will want an enthusiastic worker and learner who is prepared to see their fair share of patients, including afterhours. They will also want a registrar who is anxious to learn from the members of the practice, especially in the areas of interest of the supervisor team such as practice management, chronic diseases, geriatrics, obstetrics and procedural skills. The registrar will want enthusiastic teachers who have an organised teaching program within the practice, who make themselves available for ‘corridor teaching’ (including after hours) and who have a set of special interests that match the registrar’s interests.

Simplicity Supervisors don’t want complicated pay formulas that are difficult to administer and that can lead to arguments or misunderstandings. An extra 1% of billings is preferable to a potential misunderstanding and ill feelings caused by a four-page calculation of the benefit penalty of a oneweek, versus two-week, versus one-month or three-month billing cycle.

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You should expect to do some after-hours work if the practice provides this service to its patients. Of course, this should be no more than the other members of the practice, but recognise that even when you are on-call your supervisor is also still on-call to back you up. Do you offer to be ‘second on-call’ for the practice on other nights?

A written and signed employment agreement is a must because it formalises the negotiation. It should clarify any potential misunderstandings. Having this in writing can help to avoid the very difficult situation of “you said / I said” disagreements. Dr Patricia Baker Chair, National General Practice Supervisors’ Association

Negotiate with a ‘win-win’ attitude - neither party should feel disadvantaged Just as it is reasonable for supervisors to check your references, it is reasonable for you to ask for details of registers who have previously worked in the practice to see how the practice teaches and treats its registrars. Check more than one — every practice has had one disgruntled registrar and sometimes it’s the registrar who didn’t fit in rather than a problem with the practice.

More than money – an initiative of GPRA

Expectations continued …

The top five things a supervisor wants their registrars to know when they negotiate • Negotiate in good faith — I want the best possible outcome for both the registrar and the practice. I’d like to think that I try to find what is important for the registrar – and in turn, the registrar empathises with the supervisor and practice and learns what is important for them. Just as a registrar may sometimes feel powerless in negotiations, sometimes this is reversed and the supervisor and/or practice owner can feel powerless. • Percentages for an employee need to be calculated differently than for a contractor An employee’s percentage may appear lower because it does not take into account superannuation, annual leave and other associated on-costs attracted by law for an employee. A contractor (GP not registrar) might be paid more – but the GP must then take all associated costs from the gross percentage. • Be willing to trade or compromise beyond money — For example, if you need to leave at a definite time to get to your daughter’s basketball practice on Wednesday, perhaps offer to work on Thursday until close. As a practice owner, I must also make sure all other staff members are getting a fair and equitable workload.

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• Practices resource costs are fixed — Many practice costs are fixed, therefore the practice continues to generate costs even when no patients are being seen. Practices operate on a profit margin of about 5%, but often this is less. As a result, small increases in percentage payments will result in large decreases in practice profitability and sometimes make the practice unprofitable. • Registrars need to be proactive and positive when arranging in-practice teaching requirements — It makes it far easier to help with teaching when I know the registrar wants to learn and if they communicate what they would like to learn. It is also good to make sure it is protected teaching time that we both deem important and valuable. Dr Bruce Willett GP, supervisor and practice owner, Queensland

Maximising your income as a registrar Many employee GPs are oblivious to the tax planning opportunities available to them. With careful planning and good advice it is possible to shave thousands of dollars off your tax bill. If you are paying less tax, you are earning more money.You’ve worked hard to earn each dollar so you should ensure that you maximise every opportunity to keep them. Tax planning helps you to do this. It is not uncommon for employee GPs to have an average tax rate in the single digits! Let’s look at some of the strategies used: • Exempt fringe benefits – If you are employed for even a single session at a ‘public benevolent institution’ (eg. a public hospital), then you could be entitled to a $17,000 gross taxable benefit. • Car deductions – Most GPs are able to claim a significant proportion of their car use. • Negative gearing – This is an excellent tax planning strategy for all GPs. • Superannuation – Although dealing with superannuation seems like the last thing you should be thinking about, it can be one of the best tax strategies for young GPs. • Home office deductions – You are entitled to claim the running expenses connected with your home office. This includes a proportion of gas, electricity and all other facilities. Other items such as desks and lamps can also be claimed and depreciated.

• Income protection insurance – The premiums for income protection insurance policies are tax deductible. • Non-slip shoes and protective clothing Specific purpose clothing is deductible. • Meal allowance - Overtime meal allowances qualify for special tax treatment and are deductible to the employer and can be exempt or deductible for you depending on the method of payment. • Overseas travel - Conference travel and travel for the purpose of maintaining an existing body of knowledge used to produce your income is tax deductible. • Telephone and internet - Depending on circumstances, you could claim a high percentage of your mobile phone, home telephone and internet costs. This is really only the tip of the iceberg with regards to tax and financial planning for employee GPs and I encourage you to begin the planning process in the early stages of your career. As the ‘Sage of Omaha’ (Warren Buffett) said, “Someone’s sitting in the shade today because someone planted a tree a long time ago.” Ravi Agarwal Partner, Medical Strategy MEDIQ Medical Financial Services mediqfinancial.com.au More than money – an initiative of GPRA

Troubleshooting

The GPRA Registrar Services team receives and answers hundreds of calls from GP registrars, practice staff and supervisors every year. This section features some of the more common enquiries we receive.

Before you call GPRA, please check the elements of your employment agreement. Have it handy when you call.

No employment agreement to fall back on when problems arise. Make sure an employment agreement is created, discussed and signed before you begin work. If you do not have one and have started work, request an employment agreement immediately. Your RTP will usually have an employment agreement template or you can refer to the GPRA employment agreement template. If problems have already arisen, this can be a very challenging situation. Seek advice sooner rather than later. That is why it is always best for both employee and employer to sign an employment agreement prior to commencing work.

I’m not sure what was in my employment agreement. You should retain a copy of the signed employment agreement for your records. 34

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Scan and email yourself a copy so you can always access a copy. Contact the practice for a copy of your employment agreement.

How is annual leave remunerated? Annual leave is paid at the registrar’s current relevant base weekly wage.

I’ve just started at the practice and I need to take annual leave. Annual leave is accrued over time, and a registrar needs to discuss when to take annual leave with the practice. If a registrar seeks to take a week’s annual leave in the first month of their employment, there is unlikely to be enough annual leave accrued. The practice may agree to provide for leave in advance, or refuse the request. It is only fair that leave is negotiated and agreed on as soon as possible. In almost all cases, practices are happy to plan for a registrar’s annual leave when given plenty of notice.

My teaching time was not protected. Request that your teaching time is ‘protected’ as per RACGP/ACRRM teaching standards. Ensure that your employment agreement clearly states that this time is included in your salary. It is a good idea to discuss how, when and where this teaching will occur, and plan ahead. Be positive and proactive for a better learning experience.

My teaching time and educational release time has not been paid.

Do verbal discussions about employment conditions count?

Ensure that your employment agreement clearly states that educational release and teaching time is included in your salary.

No, you must ensure that all discussions are documented in the employment agreement.

The minimum salary has been calculated using patient consulting time as 28.5 to 29 patient contact hours, in-practice teaching time as three hours, educational release as 3.5 hours and administration time as 2.5 to 3 hours per week. In-practice teaching time and educational release time should be included in your full-time workload. You can choose to work more than the minimum required 27 hours, however, consider and discuss how this will impact on the in-practice teaching and educational release. GPRA recommends that educational release and in-practice teaching time should be paid at the minimum salary rate.

I was only paid 45% of the Service Incentive Payments. According to the NMTC, SIPs (after being received by the practice) will be included in gross billings, and so the percentage that you receive for ordinary hours will apply to the SIPs (plus the statutory rate of superannuation).

How are my income and conditions applied as a part-time employee? All conditions, including the minimum salary in the NMTC, apply on a pro-rata basis, with the exception of educational release, which is half the amount of time that a full-time registrar receives.

Public holidays - what do I get paid, and do I have to work? Yes, you may have to work on public holidays. The NMTC states that public holiday rostering shall be no more onerous than that of other doctors in the practice; the workload should be shared around. If the public holiday falls on a day on which you would normally work, you either receive your normal pay and a paid day off in lieu, or 150% of your usual hourly rate or 55% of billings, whichever is greater. If you are on-call, you receive your normal hourly rate plus 55% of billings (but no day off in lieu).

Registrars and practices may wish to discuss a higher percentage for SIPs, however unless it is documented in the employment agreement, the ordinary rate will apply. More than money – an initiative of GPRA

Ready to sign?

Resources

Help GPRA

• General Practice Registrars Australia gpra.org.au - Employment agreement template - Fatigue Management in Vocational General Practice - In-practice teaching resource - National Minimum Terms and Conditions - Online earnings calculator - Terms and Conditions Benchmarking Survey • Australian General Practice Training (AGPT) program policies: agpt.com.au/Policies • Australian College of Rural and Remote Medicine training standards: acrrm.org.au • Department of Health and Ageing, Doctor Connect website: doctorconnect.gov.au • Fair Work Australia Ombudsman leave calculator: fairwork.gov.au • General Practice Education and Training: gpet.com.au • The Royal Australian College of General Practitioners training standards: racgp.org.au

Do you have a great resource to help with contracts and negotiations? Why not let GPRA know so we can share it with other registrars? Email us at registrarenquiries@gpra.org.au

gpra.org.au

Would you like to join other registrars in the development of great resources such as this? All registrar members of GPRA can join a subcommittee by emailing subcommitees@gpra.org.au

Enjoy your GP term! We hope this GPRA guide has been helpful to you and we wish you well for this next step on your general practice career path. Most registrars find negotiating their GP term employment contracts to be a trouble-free process and their training terms to be an extremely rewarding experience. If you need more specific, individual advice on negotiating your employment agreement, get in touch with your registrar liaison officer at your regional training provider – your local link to GPRA.

More than money – an initiative of GPRA

Appendix

GENERAL PRACTICE TRAINING PROGRAM National Minimum Terms and Conditions for GPT1 and GPT2 2013 GP Training Year Errata Note: All mentions of “plus 9% superannuation” should read “plus the statutory rate of superannuation as determined by the Commonwealth from time to time.”

1. Purpose and Application 1.1 This agreement is operative from the commencement of the 2013 GP training year and is intended for use throughout the Australian General Practice Training Program (“AGPTP”) and supersedes any previous agreement. These minimum terms and conditions apply, by agreement between General Practice Registrars Australia (“GPRA”) and the National General Practice Supervisors’ Association (“NGPSA”), to all GP Registrars engaged in GPT 1 and GPT 2 who are not covered by the Medical Practitioners Award 2010 or any other applicable award or industrial instrument. 1.2 These minimum terms and conditions will be reviewed and updated nationally by three representatives each of the GPRA and NGPSA in July 2014, and every two years thereafter. The Australian Medical Association Ltd (“AMA”) agrees to notify the GPRA and NGPSA when the review is due and to assist them in reaching agreement on the terms of the update.

– – – – – – – – – – –

1.4 This agreement continues in force, and applies to all registrars and supervising practices, until agreement is reached on the terms of the next update.

2. Statement of Goodwill The GPRA and NGPSA acknowledge that a mutual attitude of goodwill must exist for both the registrar, the supervisor and the practice to extract maximum benefit from this term of training and employment. The GPRA and NGPSA agree that the parties they represent will make all reasonable efforts to work and learn together in a spirit of mutual trust and goodwill.

1.6 For the purpose of this agreement: –

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“GPT 2” refers to the second six-month placement in a general practice or equivalent setting within the AGPTP. “registrar” refers to the GP registrar on the AGPT program “practice” refers to the training general practice employing the registrar “PIP” refers to the Medicare Australia Practice Incentives Program “SIP” refers to the Medicare Australia Service Incentives Payment “RACGP” refers to the Royal Australian College of General Practitioners “ACRRM” refers to the Australian College of Rural and Remote Medicine “AGPT” refers to Australian General Practice Training “AMA” refers to the Australian Medical Association “NGPSA” refers to the National General Practice Supervisors Association National Minimum Terms and Conditions for Basic and Advanced GP Terms 2013 GP Training Year “GPRA” refers to the General Practice Registrars Australia “supervisor” refers to a GP accredited by a college as a supervisor “college” refers to RACGP and ACRRM

1.3 These minimum terms and conditions are intended to establish a fair and reasonable basis of employment for registrars in order to support an appropriate educational environment.

1.5 This agreement aims to reflect and uphold the standards of General Practice training.

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“GPT 1” refers to the first six-month placement in a general practice or equivalent setting within the AGPTP;

Additionally, they acknowledge that this agreement is not comprehensive and that every effort will be made to reasonably discuss and resolve other difficulties as they arise. This agreement is based on the relevant AGPT and college policies in place as at 1 July 2010. The NGPSA and the GPRA agree to discuss any significant changes to AGPT and college polices that may affect the operation of this agreement. The parties agree that they will use their best endeavours to arrange an equitable distribution of work in the practice with the intent that the registrar obtains training across the spectrum of general practice and shares the patient workload with other doctors in the practice. 3. Nature of Employment 3.1 Registrars engaged in GPT 1 and GPT 2 are employed in the capacity of an employee and an employment agreement will be negotiated between the practice and the registrar that at least satisfies the minimum terms and conditions contained in, and using the framework defined in, this agreement. 3.1.1 For information on the difference between a contractor and an employee, it is recommended that registrars and practices refer to the definitions outlined on the Australian Taxation Office website. ato.gov.au/businesses/content.asp?doc=/ content/00095062.htm Involvement in an apprentice or trainee situation has a significant impact on whether an individual is viewed by the ATO as a contractor or an employee. 3.2 A copy of the employment contract (signed by the employer and the registrar) must be exchanged by the employer and the registrar prior to commencement of his/her employment in a training position. More than money – an initiative of GPRA

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3.3 An Australian Defence Force Registrar may be bound by employment contracts that differ from the requirements outlined in 3.1 above. 4. Categories of employment Full Time employment a) ‘Full-time employment’ means that a registrar is employed to undertake all duties, as detailed in clause 5.1.1 for 38 hours / week averaged over a 4 week cycle. A full-time salary is based on a 38 hour week. National Minimum Terms and Conditions for Basic and Advanced GP Terms – 2013 GP Training Year 4 b) ‘Full-time equivalent’ is a workforce calculation based on the total number of doctor’s working across a 38 hour period. c) ‘Full time Training’ is determined by the relevant GP Colleges (RACGP and ACRRM) Part-time employment a) ‘Part-time employment’ is any number of hours less than 38 hours / week averaged over a 4 week cycle. A part-time salary is pro-rata based on a 38 hour week. b) ‘Part-time training’ is based on the number of hours less than those specified by the respective GP Colleges (RACGP and ACRRM) of patient face-to-face time. As a guide, RACGP counts part-time as being 8 sessions or less with sessions averaging 3.5hours. c) A registrar by the definitions above can be considered a part-time employee, and still may fulfil requirements for full-time training.

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5. Work Hours 5.1 Ordinary Hours 5.1.1 The ordinary hours of the registrar are calculated as the time between commencing and finishing work each day. Ordinary hours do not include on-call time and meal breaks. Ordinary hours shall be worked in periods of not less than 3 hours and no greater than 12 hours on any one day. Ordinary hours for payment purposes are between 8am and 8pm Monday to Friday and 8am and 1pm on Saturday. The ordinary hours will be agreed prior to the commencement of the term. Ordinary hours include: a) normal general practice activities such as: • Scheduled consulting time (whether seeing patients or not) • Home, hospital and nursing home visits including travel time • Administrative time (e.g. writing notes, telephone calls, reports) b) practice based teaching time; and c) educational release time. 5.1.2 If the registrar is employed on a full time basis, the ordinary hours of the registrar shall: a) be 38 hours per week averaged over 4 weeks, of which not less than 27 hours per week averaged over 4 weeks shall be scheduled patient contact time; b) be worked over at least four days per week averaged over 4 weeks; 5.1.3 If the registrar is employed on a part-time basis, all the conditions in this agreement apply on a pro rata basis with the exception of educational release and teaching time which, for part-time training, is equivalent to half that for full-time training, irrespective of the annual numbers of hours worked each week.

The ordinary hours of a part time registrar shall: a) be no less than 10.5 hours per week averaged over 4 weeks of which not less than 9 hours must be scheduled patient contact time; and b) be worked over not less than 2 days per week.

5.4.2 On Call

5.2 Workload

During both the GPT 1 and GPT 2 term, there should be a maximum on average of four patients per hour. GPRA and NGPSA realise that in times of special circumstance, such as emergencies, staff illness and outbreaks of illness this workload may vary.

5.3 Fatigue management The parties agree that fatigue management is an important issue and is the responsibility of both parties.

Registrars and practices must take responsibility for ensuring that registrars are not unduly affected by fatigue and excessive workload.

Registrars and practices are encouraged to maintain open dialogue in relation to fatigue management and act quickly to put in place arrangements to address fatigue issues.

5.4 After Hours , On Call and Additional Ordinary Hours 5.4.1 After hours

Where a practice is normally open outside of ordinary hours, the registrar may be rostered to work. This is considered to be a normal part of general practice. These arrangements shall be no more onerous than those of other full time doctors in the practice (pro rata for part-time registrars).

The registrar may be rostered to be on call. This is considered to be a normal part of general practice. These arrangements shall be no more onerous than those of other full time doctors in the practice (pro rata for part-time registrars).

5.4.3 Additional ordinary hours The registrar may agree to work additional ordinary hours by negotiation with the practice. Where this is done during regular hours, it is not considered overtime, and no overtime is payable on those hours. Registrars may decline practice requests to work additional ordinary hours without penalty or disadvantage. It is noted additional ordinary hours are different to special circumstances as outlined in 5.2 and after hours in 5.4.1.

6. Supervision 6.1 The employer shall provide supervision in accordance with AGPT guidelines. 6.2 Appropriate, mutually agreed supervision must be available at all times for after hours and on-call work. 6.3 Except in circumstances approved by the colleges the supervisor or his/her delegate should be available to attend in person, should the registrar request this in the event of an emergency. 7. Remuneration 7.1 Pay for ordinary hours 7.1.1 The following salaries are based on a fulltime, 38 hour week. 7.1.2 Gross billings include all fees generated by the registrar from all sources. For Service Incentive Payments and Practice Incentive Payments refer to clause 13.7. More than money – an initiative of GPRA

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7.1.3 Part-time salaries during GPT1 and GPT 2 shall be calculated on a pro rata basis.

(The minimum salary has been calculated using patient consulting time as 28½ - 29 hours, teaching time as 3 hours, educational release as 3½ hours and administration time as 2½ - 3hours (per week). Administration, including report writing, is expected to occur during ordinary hours.)

7.1.4 GPT 1 7.1.4.1 The salary for a registrar at the GPT 1 level is the greater of a) or b) below calculated over a 3 monthly cycle. a) The minimum annual salary for a full time registrar is $72,760 ($1,399.23/week), plus the statutory rate of superannuation as determined by the Commonwealth from time to time; Or b) The relevant percentage (refer to table below) of in hours gross billings, plus the statutory rate of superannuation as determined by the Commonwealth from time to time: c) Annual leave should be paid separately at the minimum annual salary rate.

PERIOD From

7.1.5 GPT 2 7.1.5.1 The salary for a registrar at the GPT 2 level is the greater of a) or b) below calculated over a 3 monthly cycle. a) The minimum annual salary for a full time registrar is $87,476.00 ($1,682.23/week), plus the statutory rate of superannuation as determined by the Commonwealth from time to time; Or b) The relevant percentage (refer to table below) of in hours gross billings, plus the statutory rate of superannuation as determined by the Commonwealth from time to time:

Percentage of billings

Rate of superannuation

30/06/2013

45.00 %

9.00%

1/07/2013

30/06/2014

44.90

9.25%

1/07/2014

30/06/2015

44.79 %

9.50%

** Note the above calculation is based on ensuring that the gross percentage of the registrar remains constant at 49.05% so as not to disadvantage either the registrar or the supervisor in light of the changes to the supperanuation legislation.

c) Annual leave should be paid separately at the minimum annual salary rate. 7.1.6 A review of remuneration and pay cycles should occur after 3 months of employment. 7.1.7 For the purposes of 7.1.4 and 7.1.5: a) The fortnightly rate of pay will be ascertained by applying the following formula: Fortnightly Rate of Pay = Annual Salary 26.07 b) The hourly rate of pay will be ascertained by applying the following formula: Hourly Rate of Pay = Fortnightly Rate of Pay 76 7.1.8 The minimum salaries of $72,760 and $87,476 shall apply from the start of the 2013 training year. 7.1.9 The salaries prescribed in this agreement will be reviewed at the end of each calendar year and adjusted upwards in line with movements in the CMBS, VR Level B consultation item. Both parties shall accept the determination of the AMA with respect to the amount of indexation. The new salaries will become applicable in the new training year immediately following this. 7.2 Overtime Overtime is calculated on weekly hours (excluding on call work) in excess of 38 averaged over a 4-week cycle, or in excess of ordinary scheduled hours for part-time registrars. Registrars will not be expected to work overtime to any greater extent than National Minimum Terms and Conditions for Basic and Advanced GP Terms – 2013 GP Training Year 8 other full time doctors in the practice (pro rata for part time). By agreement overtime can be: a) taken as time off in lieu at the ordinary time rate (ie an hour for each hour worked),

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at a time agreed between registrar and supervisor, but within one month). or b) paid at 150% of the ordinary time rate, plus 9% superannuation. 7.3 Pay for after hours and on call 7.3.1 For after hours and on-call work at the practice or off site, the registrar will be paid a minimum 55% of gross billings, plus 9% superannuation. 7.3.2 Where after hours and on-call involves hospital – based work the registrar will be paid a minimum 55% of gross billings, plus superannuation, plus 55% of the on-call allowances paid by rural hospitals where applicable. 7.4 Time of Payment 7.4.1 A registrar’s salary for all work undertaken in connection with the practice shall be calculated, according to billings, and paid at least fortnightly and will not be delayed pending payment for consultations (ie pay is calculated in relation to billings and not receipts). 7.4.2 Payment for hospital work will be paid in accordance with the hospital billing cycle. 7.4.3 The practice must provide at registrar request access and explanation of their patient billing information. 8. Leave 8.1 Annual Leave 8.1.1 A registrar shall be paid two weeks annual leave per 6 months full-time period (pro rata for a part-time registrar). Any unused leave shall be paid out on termination of employment. There is no leave loading entitlement. More than money – an initiative of GPRA

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8.1.2 Annual leave will be paid at the registrar’s current relevant base weekly wage. 8.2 Personal/Carer’s Leave 8.2.1 Personal/carer’s leave means leave taken due to personal illness or injury (sick leave) or to provide care or support for a member of the registrar’s immediate family or household who requires care or support due to personal illness or injury, or an unexpected emergency (carer’s leave). 8.2.2 Unless otherwise specified under legislation, paid personal/carers leave for a full-time registrar is accrued on the basis of 1/26 of the number of ordinary hours worked during the previous completed four week period. For a full time registrar working 38 hours per week, this will amount to 38 hours (ie:5 days) over a 26-week term. 8.2.3 A full-time registrar working 38 hours per week will be entitled to an advance of 38 hours paid personal/carer’s leave for each 6 months full-time period of employment on commencement of the term. For a part-time registrar this shall be calculated on a pro rata basis. 8.2.4 In the event the registrar has taken unaccrued personal/carer’s leave and terminates her/his employment, the practice is entitled to withhold an amount equivalent to those hours taken as unaccrued sick leave. 8.2.5 The calculation of pay for personal/carer’s leave shall not be on a percentage of billings, but each day off sick, shall be paid as follows: a) GPT 1: $1,399.23/38 hours = $36.82 per hour b) GPT 2: $1,682.23/38 hours = $44.27 per hour

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8.2.6 Personal/carers leave is calculated on a pro rata basis for part-time registrars using the formula prescribed in 8.2.2 above. 8.2.7 A registrar is entitled to an additional two days of unpaid carer’s leave on each occasion that a member of the Registrar’s immediate family or household requires care or support due to (a) a personal illness, or personal injury, affecting the member; or (b) an unexpected emergency affecting the member. 8.2.8 Unpaid carer’s leave can only be taken once all paid personal/carer’s leave entitlements have been used. 8.3 Compassionate Leave

A registrar shall be entitled to up to two days paid compassionate leave, which can be taken upon the death of a member of the registrar’s immediate family or household, or to spend time with a seriously ill, injured or dying person who is a member of the registrar’s immediate family or household. Compassionate leave taken shall be paid at the rate of $36.82 per hour for GPT1 and $44.27 per hour for GPT2.

8.4 Definition of immediate family or household

For the purpose of 8.2 and 8.3 above, immediate family household means the registrar’s spouse (including de facto spouse, former spouse, or former de facto spouses), child, parent, grandparent, grandchild or sibling. In addition, immediate family includes the child, parent, grandparent, grandchild or sibling of the registrar’s current or former spouse (including de facto spouses).

8.5 Parental Leave Parental leave requirements shall be dealt with according to the Fair Work Act 2009 (Cth) and applicable instruments. Requirements under the Fair Work Act shall be the minimum conditions which will apply to parental leave.

Where maternity leave applies, a registrar may begin maternity leave within 6 weeks of the expected birth of the child (i.e. in week 34 of her pregnancy).

Where maternity leave does not apply and a registrar will be terminating the employment contract due to pregnancy, the employer will allow the registrar to do so within 6 weeks of the expected birth of the child (i.e. in week 34 of her pregnancy).

8.6 Study Leave

There is no automatic entitlement to study leave. Registrars who consider they may require such leave are encouraged to discuss with their practice and include such considerations in their employment agreement. Registrars shall be aware that such leave may have implications on training time and progress through the program.

9. Public Holidays 9.1

A Registrar who normally works ordinary hours on the day of the week on which a public holiday falls is entitled to that public holiday as paid leave (ie. that day is part of the registrar’s ordinary hours of work for that week).

9.2 If a registrar works on a public holiday: • In a practice that is open for normal consultations, then the registrar will receive their normal pay and a paid day off in lieu (or half day, if only one session was worked on the holiday)

or • 150% of their usual hourly rate or 55% of their billings, whichever is the greater. In this instance the registrar is not to be entitle to time off in lieu. • In an on-call capacity for a practice which is closed for normal consultations, then the registrar will receive their normal hourly rate for their usual rostered hours PLUS 55% of their billings for that day. In this instance the registrar is not entitled to a paid day off in lieu. 9.3 The allocation of public holiday rostering shall be no more onerous than that of other doctors in the practice. 10. Superannuation and Workers’ Compensation The practice will observe the requirements of superannuation law and will ensure it has insurance to cover workers’ compensation for the registrar. 11. Expenses 11.1 Travel

The registrar will be reimbursed by the practice for expenses incurred by the registrar in the use of the registrar’s motor vehicle for work purposes during ordinary hours and on call work.

Reimbursement shall be at the standard Australian Taxation Office rates. To substantiate a claim for reimbursement, the registrar will keep a travel diary.

11.2 Relocation Expenses

Unless otherwise agreed, the practice is under no obligation to meet a registrar’s relocation expenses. A registrar undertaking a rural term may be eligible for subsidised relocation expenses from the Regional Training Provider (“RTP”). More than money – an initiative of GPRA

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12. Accommodation 12.1 The GPRA and NGPSA agree that neither the practice nor the registrar should be financially disadvantaged in supporting a registrar’s accommodation. 12.2 The accommodation subsidy shall be distributed appropriately to either the registrar or the practice depending on who incurs the cost of provision of accommodation. 12.3 If a registrar is undertaking a GP term in a rural area, the practice will: 12.3.1 assist the registrar to find suitable accommodation to suit their needs (which is selfcontained, fully furnished with kitchen facilities) and is in accordance with the standard approved GPET; and 12.3.2 support the registrar in accordance with their RTP terms and conditions. 12.4 The registrar will be responsible for payment of gas, electricity and private phone usage. 13 Registrar Obligations 13.1 Medical Registration

A registrar employed in accordance with this agreement must have a current registration with the Medical Board of Australia. In the event that registration is withdrawn or conditions are imposed upon it, the registrar is required to notify the employer as soon as practicable.

13.2

Indemnity

13.2.1 During the term of employment, the registrar will hold professional indemnity insurance in respect of the work contemplated by this agreement. The registrar will, if requested by the employer, produce evidence of medical indemnity.

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In the event that professional indemnity insurance is withdrawn or altered, the registrar must notify the employer as soon as practicable. 13.2.2 The registrar authorises the practice to make inquiries of the registrar’s medical insurer to verify membership or level of insurance, as the case may be. 13.3 Release of Data 13.3.1 Practice Incentive Program: The registrar shall, if requested by the practice, consent to the release of relevant Medicare Australia data. 13.3.2 The Registrar will notify the Supervisor as to whether or not they have consented to the release of their Medicare Australia data. 13.4 Confidential information

During the registrar’s term of employment and after it has ceased, the registrar will not use or divulge any information confidential to the practice and its patients.

13.5

Incorrect Billings

As the billing doctor is responsible for any incorrect billing practices, it is recommended that registrars review their list of patient billings on a regular basis to protect themselves from inadvertent breaches of Medicare legislation. Practices shall co-operate in this process, providing prompt access to lists of patient billings and associated documentation and records.

13.6 Passing on Billings

The Registrar is obliged to pass to the practice all billings received by him or her, for work performed under the registrars provider number at the practice

13.7 PIPS & SIPS

SIP payment on receipt will be included in the gross billings. The registrar is not entitled to receive any portion of the PIP payments with the exception of aneaesthetic PIP and Obstetric PIP payments. The exact portion of these will be mutually agreed and not disadvantage either the registrar or the practice.

14. Practice Obligations 14.1 Practices will maintain records for the time periods required under state and territory law and make those records available to the registrar after leaving the practice in the event the registrar is required to respond to a complaint, claim of Professional Services Review. 14.2 Practices will pass on to the registrar during the time at the practice and afterwards the percentage of Service Incentive Payments payable to them. 14.3 Practices will provide the registrar with billing information. 14.4 Information and calculations as to billings shall be made available to the registrar at a frequency no less than that available to other employed doctors in the same practice. 14.5 Where there are no other employed doctors in the same practice, information as to billings shall be made available to the registrar at a reasonable frequency, by mutual agreement between the practice and the registrar. 15 Termination of Employment 15.1 Employment should not be terminated by the registrar or practice before the completion of the term, other than in exceptional circumstances and only where

there has been extensive discussion between the practice/GP supervisor, the registrar and the RTP. 15.2 Termination of a registrar’s employment by the practice prior to the expiration of the term should only be affected according to applicable laws. 15.3 In all other circumstances appropriate notice of termination should be given and the period of notice should be determined by mutual consent (in any event not less than 2 weeks unless by mutual consent). 15.4 Any accrued entitlements, including annual leave, must be paid to the registrar at termination, unless otherwise required by law. Superannuation contributions must be made to the relevant fund where applicable. 16. Future Employment 16.1 An agreement may be reached between the registrar and the employer regarding reasonable restrictions on the registrar’s employment, including location and time period, on leaving the training post, provided that such restrictions do not unreasonably interfere with the completion of the registrar’s training or cause unreasonable hardship for the registrar. 16.2 The supervisor, employer, practice and the registrar acknowledge that a restrictive covenant must be reasonable and should not be wider than is reasonably necessary to protect the employer’s interests when judged in terms of the duration and area of its coverage and the activities restrained. 17 Safety and Security 17.1 The GPRA and NGPSA recognise that the personal safety of a registrar, especially working alone, on home visits or in the

More than money – an initiative of GPRA

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surgery after hours is an issue to be addressed when making after hours and on-call arrangements.

18.2 Notwithstanding 18.1 above, the opportunity for individuals to refer via their Registrar Liaison Officer or Supervisor Liaison Officer to the NGPSA/GPRA for Execution page Key areas to be addressed include: advice on terms and conditions disputes • Reliable telecommunication contact for remains available as an option. any after hours, or home visits Agreed and signed by the parties, to come into effect from the commencement of the 2013 GP • Reasonable registrar rostering, with training year. consideration for commuting requirements between workplaces (including educational Execution page releases) Execution page and signed by Association the parties, to come into National GeneralAgreed Practice Supervisors • The practice is required to undertake effect from the commencement of the 2013 GP and signed the parties, to come into effect from the commencement of the 2013 GP a risk assessment and appropriate risk Agreed Dr Patricia Baker, Chairby year. training minimisation strategies in relation to thetraining year. National General Practice Supervisors Association registrar’s work environment and discuss Dr Patricia Baker, Chair this with the registrar. National General Practice Supervisors Association Signature:

[Signed by Patricia Baker]

17.2 The GPRA and NGPSA agree that if Dr Patricia Baker, Chair Date:31 October 2012 a registrar feels unsafe in a particular environment that this issue shall be [Signed by Patricia Baker] addressed by the practice. If the registrar Signature: Signature: continues to feel unsafe then the registrarDate:31 October 2012 [Signed by Patricia Baker] 31 October 2012 may invoke the dispute resolutionGeneral processPracticeDate: Registrars Australia outlined in clause 18. General Practice Registrars Australia General Practice Registrars Australia 18. Dispute Resolution Dr Edward Dr Edward Vergara, Chair Vergara, Chair 18.1 Where a dispute arises between the Dr Edward Vergara, Chair registrar and the practice over the terms and conditions of employment, the parties should utilise the dispute resolution [Signed by Edward Vergara] Signature: process adopted by the RTP. During the Signature: Signature: [Signed by Edward Vergara] [Signed by Edward Vergara] dispute resolution process, both parties 31 October Date: 31Date: October 20122012 Date: 31 October 2012 shall endeavour to continue to work in an appropriate and professional manner.

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More than money – an initiative of GPRA National Minimum Terms and Conditions for Basic and Advanced GP Terms

2013 More than Money A negotiation guide for GP registrars PUBLISHED BY General Practice Registrars Australia Ltd Level 4, 517 Flinders Lane Melbourne VIC 3001 T 1300 131 198 F 03 9629 8896 E enquiries@gpra.org.au W www.gpra.org.au ABN 60 108 076 704 ISSN 2201-7356 50

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