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General Practice Students Network GUIDE 2010

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GENERAL practice: 10 Things I Like About You Whoâ&#x20AC;&#x2122;s your local GPSA? Exploding the GP myths What You Can Earn as a GP

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Aspire has been prepared by the General Practice Students Network (GPSN). Aspire has been designed to assist medical undergraduates in making informed decisions about their future training and career directions. The guide is set out in colour-coded sections for easy navigation. Aspire has been produced using sustainable, environmentally friendly printing techniques. This reflects GPSN’s ethos of supporting tomorrow’s GPs in their quest for sustainable careers in General Practice.

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Welcome Welcome to Aspire 2010, the Medical Students Guide to General Practice. The medical field is a complex tangle of specialties, all with their own unique opportunities to offer. As medical students planning our future careers, we have the great task of cutting through this jungle of options to find the path that best suits us. Aspire presents an up-to-date guide to General Practice that helps us explore this specialty. Contained within this booklet are the personal experiences of various GPs, GP Registrars and medical students, an overview of training pathways and a wealth of knowledge about the world of General Practice. The name Aspire captures GPSNâ&#x20AC;&#x2122;s attitude to General Practice â&#x20AC;&#x201C; that it is a challenging specialty worth aspiring to as a career of first choice. GPs are first-line warriors in confronting and diagnosing many health issues. 2

The opportunities presented in terms of flexibility, work-life balance, continuity of care and diversity make this specialty an interesting and rewarding one. GPSN welcomes readers of Aspire to join and support us as we continue to increase student and community exposure to the field of General Practice. Thank you to the many writers who have generously given their time to share their experiences and expertise, the management and staff of GPRA and the editorial team. I would also like to acknowledge the Schwartz Foundation and our founding partner, General Practice Education and Training (GPET), for their financial support. The continued support of our founding sponsor MDA National,

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as well as major sponsors Avant Mutual Group, North Coast GP Training, Northern Territory GP Education and WentWest Ltd, has been fundamental to GPSNâ&#x20AC;&#x2122;s ability to provide resources such as Aspire for our members. Finally, a special thanks to the GPSN National Executive and Council for continuously sharing their vision of GPSN and passion for General Practice with the local university clubs and members. On behalf of GPSN we hope you enjoy reading Aspire and we wish you all the best in your future endeavours. Please feel free to email gpsn.publications@ gpra.org.au to give your feedback on this guide. Kristen Tee Medical Editor Aspire 2010

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A message from the

GPSN Chair As GPSN Chair, I am so pleased to be a part of Aspire and GPSN in general. GPSN began in the imagination of a few and has blossomed to become the fastest growing medical student organisation in Australia. Can you believe we have over 4,000 members and a presence in every medical school? GPSN provides a forum for students interested in General Practice and those who just want to keep an open mind about future career options. Students can attend career evenings, clinical evenings and networking events in a wonderfully supportive environment. Events are arranged locally, however we are also a national organisation with government support. Very few other student organisations can boast such a footprint.

The information we have put together in Aspire presents you with facts and real-life stories from GPs and GP Registrars that shatter the myths and give you an insight into what a career in General Practice is really all about. In short, rich, rewarding, flexible and very diverse. What an exciting time to be involved with a group associated with General Practice! As you may be aware, the Commonwealth Government currently has a health reform agenda and recently announced an increase in GP training places from the current level of 900 in 2011 to 1,200 by 2014. ď ľ

This, together with a commitment of further significant funding for General Practice, underlines the importance placed on General Practice by the Government as the centrepiece of Australia’s primary health care into the future.

If you are not yet a member of GPSN, do consider joining. It costs you nothing – just a few moments of your time. Visit our website www.gpsn.org.au and have a look at what we offer, then follow the link to your local university for your local events.

I would urge any medical student to join GPSN. Even as a future eminent cardiologist, you will know that a GP can read an ECG! Kerry Summerscales 2010 GPSN Chair gpsn.chair@gpra.org.au

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Contents Produced with funding support from

About this guide Welcome A message from the GPSN Chair

1 2 4

Aspiring to General Practice General Practice – 10 things I like about you 12 Why choose General Practice? 14 GP snapshot 19 "Why I chose General Practice" 20 General Practice mythbusters 22 Not just a GP 26

General Practice at med school Network with GPSN Meet your local GPSA A year in the life of GPSN GPSN Schwartz First Wave Scholarship Program “My GPSN Schwartz First Wave Scholarship experience” Other scholarships for med students 5 top tips to make your GP rotation count

30 36 44 46 48 52 56

After med school, what next? Think like a GP in hospital PGPPP – Try it on for size "My PGPPP experience"

58 60 62

Real-life GP adventures Luck of the Irish Doctor on ice Diary of a rural doc

76 80 84

Money matters What you can earn Incentive payments

92 96

Prof. Michael Kidd is the patron of the General Practice Student Network (GPSN). After studying medicine

Keeping your balance Part-time, smart time Being resilient

at the University of Melbourne, he entered the General Practice training program in 1985. He joined Monash

100 102

University as an academic GP Fellow and completed his Doctorate of Medicine there in 1995. His doctoral research focused on the challenges in GP education and innovative technology-based methods of teaching.

About General Practice training

GPRA wishes to acknowledge our sponsors for supporting this publication:

The GP training landscape 107 The RACGP Fellowship 110 The RACGP’s Fellowship in Advanced Rural General Practice (FARGP) 114 The ACRRM Fellowship 116 The ADF: a force in GP training 120 Jargon buster 124 The 10 Year Moratorium and rural training 130 Applying for GP training 132 Regional Training Providers in Australia 134

GPSN Founding Sponsor: MDA National Insurance Pty Ltd

Info file GPSN Calendar 2010

136

GPSN Founding Partner: General Practice Education and Training Ltd Founding Benefactor: Dr Jerry Schwartz, the Schwartz Family Co. Major Sponsors: Avant Mutual Group, North Coast GP Training and Northern Territory GP Education, WentWest Ltd Co-Sponsors: Australian College of Rural and Remote Medicine, Beyond Medical Education, General Practice Training Valley to Coast, Matraville Medical Complex, McMasters’ (Vic) Pty Ltd , MIMS Australia, Medical Insurance Group Australia, National E-Health Transition Authority Ltd, Royal Australian College of General Practitioners, Rural Workforce Agency Victoria and The Doctors’ Health Fund Business Partners: Australian Doctor Magazine, Medical Observer, Ochre Recruitment Pty Ltd and Regional Training Providers Medical Editor: Kristen Tee. Subeditor: Jan Walker. Graphic Design: Marie-Joelle Design & Advertising. Marketing: Kate Marie. Printing: Fishprint. GPRA and GPSN wishes to thank all the contributing authors for their work and guidance. We also thank the Commonwealth Department of Health and Ageing for their continued support and assistance.

Design your own career as a GP What kind of GP will you be? Your career your way This academic life Travel while you train

GPSN would like to acknowledge the support of our patron, Professor Michael Kidd, and his invaluable contribution to General Practice.

66 68 72 74

Cover image: Clockwise from sunglasses – Jonathon Tey, Bond University; Daniel Foong, University of New South Wales; Dana Quah-Smith, University of Adelaide; Poh Chien Yen, University of Adelaide; Joel Vosu, University of Western Sydney

All rights are reserved. All materials contained in this publication are protected by Australian copyright law and may not be reproduced, distributed, transmitted, displayed, published or broadcast without the prior written permission of General Practice Registrars Australia Ltd (GPRA) or in the case of third party materials, the owner of that content. You may not alter or remove any trademark, copyright or other notice from copies of the publication. All efforts have been made to ensure that material presented in this publication is correct at the time of publishing. Due to the rapidly changing nature of the industry, GPRA does not make any guarantee concerning the continued accuracy or reliability of the content.

GENERAL PRACTICE STUDENTS NETWORK

A joint initiative of GPRA and AMSA

GPSNâ&#x20AC;&#x2122;s primary role is to function as a General Practice interest group, seeking to promote the beneďŹ ts of a life and career in General Practice. With various programs focussed on mentoring, peer support, networking and research, GPSN aims to become the largest student network promoting General Practice. GPSN is administered by General Practice Registrars Australia (GPRA) and is supported by a funding grant from General Practice Education and Training (GPET).

Produced with funding support from

1 Aspiring to

General Practice General Practice gives you more variety, flexibility, professional challenges and lifestyle options than any other medical specialty.

Choosing a career in General Practice

General Practice

10 THINGS I LIKE ABOUT YOU

Want the fast facts on General Practice? Here are 10 compelling reasons to love it as your future profession.

1 2 3 4 5 6 12

General Practice is officially a specialty. In 1999 the Australian Medical Council (AMC) officially listed General Practice as one of the medical specialties recognised in Australia.

General Practice is the hub of health care. As a GP, you are usually the first doctor people see. The family doctor holds a special place within the family and the community.

General Practice is very diverse. Want to use all the knowledge you learnt at med school, not just a little bit? You never know what is going to walk through the door in General Practice.

You can design your own career. There’s plenty of scope to sub-specialise and be the GP you want to be. No other specialty offers so many diverse special interests to pursue during training and practice.

Life’s never boring. Every day is different and professionally challenging. You can mix it up by working different sessions and following special interests. Variety is the spice of life!

It’s all about people. General Practice has more patient contact and continuity of care than any other specialty. You’ll also work as part of a collegiate team with other GPs and allied health professionals.

7 8 9 10

It offers work-life balance and a great lifestyle. Choose the hours you work with time for family, friends and personal interests. You can train or work part-time and take time off for travel. General Practice is very flexible!

The vocational training is excellent. Entry into General Practice training requires full medical registration (PGY2) and competitive entry via GPET. Length is three to four years with up to 12 months reduction for Recognition of Prior Learning (RPL). Final qualification is Fellowship of the Royal Australian College of General Practitioners (FRACGP) and/or Fellowship of the Australian College of Rural and Remote Medicine (FACRRM).

GPs are in demand. Australia’s GPs work everywhere from Antarctica to large cities, rural towns and remote settlements. A GP can find work just about anywhere.

The money’s good too. As a GP you can make around $200,000 a year without sacrificing your lifestyle. GPs also have the lowest medico-legal premiums of any private practitioners. You can work for others or consider starting your own practice.

Contributed by Vicky Phan and Jan Walker

Choosing a career in General Practice

Why choose

General Practice? Is General Practice the career choice for you? A newly trained GP outlines the pros and cons to help you decide. As you progress through your internship and early RMO years, a time comes when decisions have to be made about your future training and specialisation. You get exposed to most medical specialties as a junior doctor in the hospital system, but General Practice is a bit of a mystery.

What do I like about General Practice?

I love the wide variety of work, covering aspects of every specialty. I like to know a little bit about everything compared to a lot about one or two things. Over time, one can build a relationship with the patient, their family and community. Patients come back and see me “As a GP you can and bring their families. I really get to know what makes them enjoy a healthy tick and what impacts upon their lifestyle and health beyond the physical.

Fortunately, this is changing thanks to the Prevocational General Practice Placements Program, commonly work-life known as the PGPPP. (For more information about the PGPPP, see page 60.) I would certainly recommend trying one of these terms. You may find that General Practice is for you. If not, at least you will get some idea of what the GP work environment is like, which will be useful regardless of your future specialisation. So how do you know if General Practice is the right career for you? Here are a few questions I have asked myself and at least some of the answers.

balance.”

Early intervention and screening, and a trusting relationship, can impact upon a patient’s entire life. Being an advocate for patients is something I enjoy, especially for those with chronic conditions who have to navigate the health system. Rural medicine has additional rewarding challenges, including procedural and Accident and Emergency skills. These are all things I like about General Practice.

As a GP you can enjoy a healthy lifestyle and worklife balance. The work environment, flexibility in hours and part-time options are attractive. The training environment offers so many options both during and after training, and there is financial support for training via government incentive payments. (For more information, see page 96.) Travel, both within Australia and overseas, is possible with forward planning. You can follow a love of research, complete your training part-time or pursue almost any special interest. Sports Medicine, Palliative Care, Drug and Alcohol, Psychiatry, Paediatrics, Family Planning, Obstetrics, Anaesthetics, Emergency, Antarctic Medicine and more can all be catered for. There are opportunities to run your own business in the future and to learn this during training while you are employed under protected conditions. And every day is different.

What qualifications will I end up with? There are two colleges of General Practice – the Royal Australian College of General Practitioners (RACGP) and the Australian College of Rural and Remote Medicine (ACRRM). Registrars may complete Fellowship of RACGP (FRACGP) and/or Fellowship of ACRRM

(FACRRM) to gain vocational registration to work unsupervised in Australian General Practice. The FACRRM course has an emphasis on the skills required for rural and remote practice so training takes place mostly in rural and remote locations but once the qualification is complete, Fellows may practise anywhere in Australia. The FRACGP curriculum covers broad General Practice with plenty of scope for special interests, including some rural medicine skills. For those doing FRACGP with an interest in obtaining additional skills to practise in rural areas, there is the option of the Fellowship in Advanced Rural General Practice (FARGP) run by the National Rural Faculty of the RACGP, which may be studied concurrently and awarded after completion of the FRACGP. The overall vocational training program is called the Australian General Practice Training program (AGPT), which is administered by a company called General Practice Education and Training Ltd (GPET). It delivers training through a number of Regional Training Providers (RTPs) that respond to the health care needs of various regions across Australia. An alternative training route for those wishing to train in Australia’s most remote locations is the Remote Vocational Training Scheme (RVTS). 

“I love the wide variety of work, covering aspects of every specialty. I like to know a little bit about everything compared to a lot about one or two things.” 15

Choosing a career in General Practice

(For more information about the structure of General Practice training, see page 107.)

What are the employment conditions? General Practice training differs in that it usually occurs in a private practice environment. Remuneration for Registrars during training is protected by the National Minimum Terms and Conditions (NMT&C) document. This document is brokered by Registrar representatives from General Practice Registrars Australia (GPRA) and Supervisor representatives from the National GP Supervisors Association (NGPSA). It stipulates the minimum salary or percentage of billings that must be paid to the Registrar for hours worked, whichever is highest. (For more information about salaries, see page 92.) Unlike in many other training programs, the Registrar is paid to learn, with a certain number of education sessions and one-on-one teaching by the GP Supervisor at the practice included in the paid sessions. Registrars are also released from working at the practice to attend

HOW MANY WAYS DO YOU LOOK AFTER YOURSELF?

education sessions organised by their RTPs in their first 12 months of GP Terms (RACGP) or Primary Rural and Remote Training (ACRRM).

How long does it take? The Australian General Practice Training program usually takes three years for the FRACGP curriculum or four years for the FACRRM curriculum. A fourth year of Advanced Rural Skills Posts (ARSPs) may be added to the FRACGP program to attain the optional FARGP. The first of these years is undertaken in the hospital and must be after the internship. However, there are ways to reduce this time. If you already have additional years of hospital experience it is possible to have these counted retrospectively by applying for Recognition of Prior Learning (RPL), enabling you to shorten your training time by a maximum of 12 months or enabling you to undertake Elective Terms rather than Hospital Terms to complete your training time. The length of training can also be extended in a number of ways. This includes part-time training, Advanced Academic Posts, mandatory Elective Terms or leave. You can tailor it to suit you. 

Looking after you - The Doctors’ Health Fund When you’re busy living life to the full you don’t expect things to go wrong, but if the unexpected strikes, you’ll be glad you are prepared with the right health insurance so you can concentrate on enjoying life. Join your not-for-profit private health insurance fund which offers high quality health insurance with the flexibility for you to choose the hospital and extras insurance that works for you. With hospital insurance, from the very economical ‘Smart Starter’, to ‘Top Cover’ with the greatest medical benefits in Australia based on AMA List fees. The choice is yours. For all the information you need and to join visit www.doctorshealthfund.com.au. Contact us at info@doctorshealthfund.com.au or call 1800 226 126.

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Choosing a career in General Practice

GPsnapshot Points to consider The downsides – yes there are a few negatives – but with preparation they can be managed. The General Practice environment – adjusting to private practice, the Medicare Benefits Schedule and fee-for-service models. The effect of government legislation to address critical workforce shortages. GP Registrars must meet compulsory geographical requirements for training (rural and outer metro requirements). This most likely involves relocation once and sometimes twice during training. This can get more difficult if you have a partner, family, mortgages or other responsibilities but with forward planning stress on the family can be reduced. Multiple stakeholders in General Practice training and ongoing changes to Australia’s health care system, which can add layers of complexity to General Practice and General Practice training.

Fortunately, General Practice Registrars Australia (GPRA) advocates on your behalf for quality training and good conditions for GP Registrars.

There are 100 million consultations between Australians and their general practitioners each year

Having recently completed my training, I can say I had a great experience, was generally well supported and very happy with my career choice. General Practice could be just what you are looking for.

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

90% of the population consult with a general practitioner at least once each year

FACT FILE

There are more than 22,000 general practitioners in Australia

For more information, visit www.gpra.org.au or www.agpt.com.au

There are 900 training places for GP Registrars in 2011, with this number to rise to 1,200 by 2014 57% of GP Registrars are in the General Pathway; 43% in the Rural Pathway

Choosing a career in General Practice

Abhi’s tips on choosing the right specialty

“ Why I chose General Practice” Dr Abhi Varshney is the Royal Australian College of General Practitioners’ 2009 Registrar of the Year. But he almost never became a GP at all. As a hospital doctor, did you see yourself in General Practice? When you’re doing your training, the way you see your career heading depends very much on the people you work with. I was lucky enough to work with some people who were really passionate about Surgery and particularly Orthopaedic Surgery so that was originally what I wanted to do. I did all the compulsory terms and then all my terms after that were Surgery or Orthopaedic Surgery.

Did you initially even consider General Practice? No. When I was a medical student I went through the process of a General Practice rotation but it wasn’t a good experience. Basically I sat in the corner and didn’t do anything.

What changed your thinking? I was doing a Registrar job in Orthopaedics when I had a motorcycle accident. I was the fool who saw the trauma cases caused by motorcycle accidents but was still riding 20

my motorcycle. Fortunately, I was not badly injured but it was quite a big deal. There was ambulance, fire brigade, everything else. My bike was written off. My wife was called to the Emergency Department and she was there crying and even though they told her everything was fine she was very upset. It made me think – about the importance of spending time with the people you love. I lost the drive and desire to be at the hospital at two in the morning. Orthopaedics is very much like that.

“It made me think – about the importance of spending time with the people you love. I lost the drive and desire to be at the hospital at two in the morning.”

There is a specialty for everyone. We are fortunate in medicine to have so many choices. There is more to life than work. Medicine is a great job but there’s more to your life than that. General Practice is a specialty that allows you to have outside interests that balance the challenges of the job. Don’t make hasty judgements. Don’t dismiss General Practice until you know something about it. Experience General Practice through enjoyable social activities by joining GPSN. Do the PGPPP during your internship. This really is a great program and an excellent way to find out what General Practice is really like. Having your own patients to manage is very different from sitting in the corner as a student. (For more information, see page 60.)

What happened next? We moved from Brisbane to Sydney for my wife’s work – she’s a university lecturer in Linguistics. I did some locum work. I did some Emergency Department work. I did some work in a psychiatric hospital. I did some work in the jails in Sydney. I guess I was trying to find the thing that I wanted to do, that would suit me.

What made you take a fresh look at General Practice? I realised I really liked having lots of contact with patients. It’s amazing the privileged position we’re in when patients will open up and tell you the most personal things that they wouldn’t tell anyone else. I realised that General Practice was the one specialty that would allow me that connection with patients.

What else did you like about the idea of being a GP?

well. I didn’t have to give up Mental Health and I didn’t have to give up the procedural things. I could do all those things in General Practice – and have the life I wanted.

Is General Practice the easy option? General Practice is a specialty in its own right. The training program is quite difficult but you’re well supported. It’s not an easy option.

What’s life like now? I work from 8 till 5.30 – Monday, Tuesday, Wednesday and Friday. Every second Thursday I’m doing private assisting for an orthopaedic surgeon and on the other Thursday I’m doing preventative health care work in the corporate sector. I’m lucky to have a family that I love to spend time with. My wife is fantastic and I’ve got a three-year-old daughter and it’s very refreshing to see the world through her eyes.

It would allow me to practise in the general area of medicine and to have special interest areas as

Choosing a career in General Practice

General Practice

mythbusters Myth Myths abound about General Practice that just aren’t true. Here’s a reality check.

Myth

General Practice is all about coughs, colds and referrals.

General Practice is a poor cousin to the other specialties.

Training to be a GP is too easy.

 True

 False

Fact

General Practice is anything you want it to be.

General Practice is the profession of choice for variety, flexibility and work-life balance.

GP Registrars must complete three to four years of on-the-job training, exams and assessments to qualify for vocational registration.

 True

 False

Every day an amazing variety of presentations walk through a GP’s door, so life is never boring! General Practice is also unique in its flexibility. In fact, it’s the one specialty you can shape into whatever you want to do with your life. Many general practitioners supplement their everyday work with sessions in specific areas of interest (for example, Sports Medicine, Obstetrics, Forensic Medicine, education and research... the list keeps growing!)

 True

 False

In the hospital system, General Practice is often misrepresented as a fallback career for those who don’t make it into their preferred choice of specialty. Such misinformation is spread not maliciously but out of ignorance because hospital doctors traditionally have little exposure to General Practice. But all this is changing. There is now a “try before you buy” scheme called the Prevocational General Practice Placements Program (PGPPP) that allows junior hospital doctors to experience life in a private General Practice (see page 60). It’s a way to discover the true variety, flexibility and intellectual challenge of General Practice. And the joys of working regular hours instead of the mind-numbing hours of hospital shifts.

Myth

 True

 False

Since 1996, all new general practitioners must become vocationally registered. The introduction of formalised GP training has done much to recognise the need for structured postgraduate training in view of the complexities of primary care medicine. It has raised the competency of young GPs and promoted the status of General Practice as a specialty in its own right. Today, as in all other specialties, there is a defined pathway into General Practice through the two General Practice colleges – the Royal Australian College of General Practitioners (RACGP) or the Australian College of Rural and Remote Medicine (ACRRM). Australian General Practice Training (AGPT) is delivered through a number of Regional Training Providers (RTPs) across Australia.  23

Choosing a career in General Practice

Myth

Life is tough as a GP.

You’ll never drive a Porsche as a GP.

 True

 False

Fact

You can “get a life” as a GP with parttime training options, family-friendly hours, minimal weekend work and no on-call.

As a GP you can make around $200,000 a year without sacrificing your lifestyle, working 9 to 5, five days a week.

 True

 False

As in any profession, you take the good with the bad, but the joys and rewards of General Practice are many. Having the options to train and work part-time, with no overnight on-calls and minimal weekend work is a big plus that GPs enjoy. You dictate the hours you want to work, and even the most seductive perks of other specialties, like travelling and training in exotic locations, are all possible in General Practice.

 False

You might be surprised to learn that earnings have improved for GPs in recent years. It’s possible to make up to $200,000 or more for working around 40 hours a week leaving time to have a life as well as a nice car. (For earning capacity, see page 92 or refer to the GPSN's GP Earnings Calculator at www.gpsn.org.au/gpearnings/) There are also government incentive schemes for GP Registrars training in rural and remote areas and $30,000 for new GPs practising in outer metropolitan Unmet Areas of Need (see page 96).

Contributed by Dr Jason Ong, Jan Walker and Vicky Phan

Choosing a career in General Practice

Not just a GP “Do you want to be a specialist or just a GP?” It’s a question posed to most medical students – and that got DR Lana Prout thinking.

hroughout my medical degree I was asked by many people what I aspired to become after I finished medical school. This was usually phrased in some form of “do you want to be a specialist or just a GP?”. I never used to be fazed by this question and would simply answer that I wanted to become a rural GP obstetrician. However, as I progressed through my medical degree and have become more aware of exactly what a GP does, I am now slightly angered by such a remark. “Just a GP.” It makes it sound as though medical students should either aim at becoming a specialist, or not bother at all – something that I have found to be a very long way from the truth.

Skill, knowledge and passion In my fourth year of medical school I was privileged enough to spend an entire year based in a General Practice located in rural Victoria, under the guidance of a very experienced general practitioner. During my time there I was able to both witness and experience first-hand just how much general practitioners do as well as the skill, knowledge and passion required to do so. There was never a dull moment, and every patient encounter provided a unique learning opportunity.

Endless opportunities Since before I was even born, my GP Supervisor has been delivering babies, carrying out anaesthetics, removing skin lesions, performing X-rays, attending to emergencies, running

“During my time there I was able to both witness and experience first-hand just how much general practitioners do as well as the skill, knowledge and passion required to do so.” the local hospital, visiting patients in nursing homes, managing acute and chronic disease, counselling patients, undertaking preventative health measures, investigating and diagnosing the unknown, teaching medical students and Registrars as well as being a leader within the local community, among many other things. The opportunities available to general practitioners are, clearly, endless. Nowadays if anyone asks if I want to be “just a GP” I challenge them to spend a day with my GP Supervisor and suggest to him that all he has become is “just a GP”. Funnily enough no one has yet taken me up on that challenge.

Contributed by Dr Lana Prout

“

What I love about General Practice is not knowing who or what is going to walk through the door next. I also really appreciate the opportunity to practise every aspect of medicine.

”

Dr Don Cameron

WE CAN HELP YOU REACH YOUR CAREER TARGETS

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FIND OUT MORE www.gpra.org.au • enquiries@gpra.org.au • 1300 131 198

General Practice at Med School

Network with GPSN

General Practice Students Network

JOIN NOW!

GPSN is creating a buzz at medical campuses all over Australia. Have fun, make friends and establish valuable networking contacts while you learn hands-on professional skills and fire up your future career. It doesn’t matter whether you have your sights on a career in General Practice or you have an open mind, joining GPSN is one of the best things you can do at med school – professionally and personally.

What is GPSN? GPSN stands for General Practice Students Network. It is the first national student organisation with a focus on General Practice. There are active GPSN “clubs” at medical university campuses across Australia. Since its establishment in 2007, GPSN membership has leapt to around 4,700 and continues to grow. GPSN Membership Growth 2009-2010

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4693 4075 4111

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3643 3748 2947 2607

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GPSN’s aims in life

Who supports GPSN?

We empower medical students to make informed decisions in choosing their future vocation.

GPSN was founded by Australian Medical Students Association (AMSA) and General Practice Registrars Australia (GPRA). GPSN is administered by GPRA and financially supported by General Practice Education and Training (GPET). The original idea came from medical student and General Practice enthusiast Joe Rotella, who was GPSN’s founding Chair.

We seek to correct misconceptions about General Practice. We promote the benefits of General Practice as a career. We champion the importance of General Practice’s role in the overall medical landscape.

What does GPSN do? We provide a range of educational and professional resources of interest to all medical students including: Academic events. Professional development events. Social events. An e-newsletter and website. A scholarship.

GPSN dream team The head of the GPSN family is the GPSN Executive, which manages national operations. Chair: Kerry Summerscales (Flinders University) gpsn.chair@gpra.org.au Vice-Chair: Brooke Ah Shay (James Cook University) gpsn.vc@gpra.org.au

National Secretary: Jane George (University of Notre Dame Fremantle) gpsn.ns@gpra.org.au Publications Officer: Kristen Tee (University of Adelaide) gpsn.publications@gpra.org.au

The GPSN Executive leads the GPSN Council, which includes: One GP Student Ambassador (GPSA) from each Australian medical school. One Executive Officer (XO) from each Australian medical school. One Secretary (Sec) from each Australian medical school. The GPSA, XO and Sec run the local GPSA club for their medical school. 

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General Practice at Med School

GPRA management team Chief Executive Officer: Amit Vohra Senior Manager: Margo Field Business Development Manager: Kate Marie Project Manager: Connie Lambrou GP Compass Project Officer: Mary Lambrou National Membership Development Manager: Georgina Johnston GPSN Project and Marketing Officer: Laura Borelli Accounts and Administration Officer: Rebecca Qi

PROFESSOR MICHAEL KIDD GPSN patron Amit

Connie

Laura

Margo

Mary

Kate

Georgina

Professor Michael Kidd is the patron of the General Practice Student Network (GPSN). After studying medicine at the University of Melbourne, Prof. Kidd entered the General Practice training program in 1985. He joined Monash University as an academic GP Fellow and completed his Doctorate of Medicine there in 1995. Prof. Kidd’s doctoral research focused on the challenges in GP education and innovative technology-based methods of teaching. In 1995 Michael was appointed Professor of General Practice at Sydney University and Head of Department by 1998. In 2002 Prof. Kidd was elected President of the Royal Australian College of General Practitioners; a position he held for two terms until 2006. He has chaired a number of national and international committees working on a range of topics, including health informatics and HIV/AIDS.

Rebecca

Board of directors Chair: Dr Belinda Guest Vice-Chair: Dr Danika Fietz Dr Jennifer Mooi Dr George Forgan-Smith Dr Abhi Varshney Dr Bennie Ng Dr Lana Prout Ms Mary Wyatt Dr Wicky Wong

MBBS (Melbourne) MD (Monash) DCCH (Flinders) Dip. RACOG FRACGP FACHI FAFPM (Honorary) FHKCFP (Honorary) FRNZCGP (Honorary) MAICD

Prof. Kidd’s research interests include General Practice, medical informatics, health policy, medical education, safety and quality in primary care and the primary care management of HIV and hepatitis C. He co-authored the textbook Health Informatics: an Overview and authored the chapters on computers and HIV/AIDS in the Oxford Textbook of Primary Care. Belinda

Danika

Jennifer

George

Abhi

Bennie

Lana

Mary

Wicky

GPSN is proud to welcome such a distinguished figurehead of Australian General Practice as the inaugural patron of GPSN. 

General Practice at Med School

Join GPSN now – it’s free! Membership of GPSN is open to all students enrolled in an Australian medical program. As a member of GPSN, you become an Associate Member of GPRA.

Member benefits include: Free professional activities. Seminars, clinical workshops, careers expos and more. Free self-development opportunities. Become involved in an organised student body that offers opportunities in leadership and the chance to participate on national committees – we are always looking for enthusiastic people! Expand your CV, forge networks, enjoy travel perks. GPSN Schwartz First Wave Scholarship opportunity. You’ll be eligible to apply for the GPSN Schwartz First Wave Scholarship Program. Free guides. Receive a free copy of this guide containing a wealth of information about General Practice as a career path. Free e-newsletters. Receive a monthly e-newsletter and quarterly mailouts to keep you up to date with GPSN activities. Free personal mentoring. Do you have a question about General Practice training and lifestyle issues? Pair up with a Mentor through GPRA’s Mentors Program and ask away! Financial services and advice. Get professional advice via GPRA’s business partnership with Hub Private Planning.

3 ways to join!



Send us an email by writing to Kerry, our GPSN Chair, at gpsn.enquiries@gpra.org.au

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Join online at www.gpsn.org.au Contact your local GP Student Ambassador (see page 36)

Got a burning question? Get an answer with the GPRA Mentors Program The GPRA Mentors Program is a great way to get friendly, peer-to-peer advice on GP training. It links you with a GP Registrar or someone else involved in GP training who can answer your questions by email, phone or over a latte! Join at www.gpra.org.au

General Practice at Med School

Meet your local GPSA GPSA stands for General Practice Student Ambassador. Here our GPSAs share their thoughts on General Practice and life in general. Contact your local GPSA to join GPSN at your campus now.

Australian National University

Bond University

Deakin University

Flinders University

Griffith University

Sumit Chadha gpsn.anu@gpra.org.au

Sheital Chand and Shaiyla Sivaku gpsn.bond@gpra.org.au

Simone Weragoda gpsn.deakin@gpra.org.au

Stephanie Garner gpsn.flinders@gpra.org.au

Nikole Fry gpsn.griffith@gpra.org.au

Three words that describe me: Friendly, happy, curious.

Most memorable med school experience: In my first year I spent a morning in a GP clinic as part of the "see a doctor in action" component of our course. Learning the practical aspects of what we had been taught was challenging and entertaining. Trying to use an otoscope on a two-year-old was much trickier than I'd thought!

Most memorable med school experience: On Paediatrics rotation we were called to the birthing suite to examine a newborn about to be delivered. Seconds after delivery we were applying suction and he opened his eyes and looked at me. I was the first thing he had ever seen. Amazing!

Funniest med school moment: Thinking one of the cleaners was a doctor and trying to chat about a patient to her. What I like about General Practice: The fact that it is a generalist specialty rather than a partialist specialty.

Sheital and Shaiyla job share in the role of GPSA at their uni. My role model (Sheital): Dr Catherine Hamlin for her tireless work with disadvantaged women. Most memorable med school experience (Shaiyla): When I was in first year we had a one-off ambulance placement between 7pm and 7am. I thought I would never make it through to the morning, but that was definitely not the case. It was so exhilarating and scary and one of the best first-hand learning experiences I have had.

What I like about General Practice: The diversity of career opportunities including the option to sub-specialise in certain areas, the opportunity and flexibility to work anywhere, and the continuity of care experienced between a patient and their doctor over time.

What I like about General Practice: Variety, experience, skills, connecting with people, being a part of the community, being an important part of people's lives. ď ľ

General Practice at Med School

James Cook University

Monash University

University of Adelaide

University of Melbourne

University of New England

University of New South Wales

Hannah Bennett gpsn.jcu@gpra.org.au

Emily Jenkins gpsn.monash@gpra.org.au

Dana Quah-Smith gpsn.adelaide@gpra.org.au

Rooha Yazdani gpsn.umelb@gpra.org.au

Samira Bhuiyan gpsn.newengland@gpra.org.au

Chris Timms gpsn.unnsw@gpra.org.au

Three words that describe me: Hardworking, happy, enthusiastic.

Funniest med school moment: One of my earliest attempts to take a history somewhat stalled midway through when the patient attempted to arrange a blind date for me with one of her grandsons. When I tried to politely decline she whipped out a photo album so she could point him out, along with other unmarried relatives.

Most memorable med school experience: Going on a day attachment with the Royal Flying Doctor Service.

Funniest med school moment: Maybe not the funniest, but probably the weirdest, was my first time ever interviewing a Psych patient, and this patient insisted that I was too tense and fully grabbed my legs and started giving me a massage. I kept telling her to let me go, it's not right, she's a patient and I'm the "doctor" but she insisted it was okay because "they can't see us".

Three words that describe me: Orange raving lunatic.

Three words that describe me: Modest, stunning and brilliant. No, I would actually say handson, friendly and casual.

What GPSN means to me: I love that we now have an organisation for those of us interested in General Practice to be involved right from the start of medical school. It's great to meet and network with other students with similar interests not only from within my own medical school but around the country. I think GPSN is also really important for promoting General Practice so we can finally get rid of some of the myths and misconceptions surrounding GPs.

What I like about General Practice: The way the continuity of care facilitates strong doctor-patient relationships, and the way those relationships span both times of sickness and times of health. I love this idea of really getting to know my future patients and knowing that no matter what presenting complaint they walk in with, I will be part of the solution.

What I like about General Practice: I think that there is more continuity of care, not just throughout an individual's lifetime but also throughout generations of families. I also like to think that you are more able to choose the hours you work in General Practice.

What I like about General Practice: I believe sometimes patients may feel lost or overwhelmed in the big hospital systems, but if they have a GP they can really talk to who can coordinate their management they should be able to benefit from the best medical care.

My role model: Right now itâ&#x20AC;&#x2122;s Dr John Murtagh. I just bought his book and it is ridiculously helpful. What GPSN means to me: Before I was a GPSA I had little to no understanding of General Practice, but after a year of skills sessions and GP guest speakers, General Practice looks like it would be perfect for me.

What I like about General Practice: General Practice can give me the flexibility to go surfing in the morning but still treat patients in the afternoon. As a guy from a small coastal town I want to use General Practice to travel internationally, which I've never done. Best GPSN event: Our careers night. We got to hear some fantastic speakers while enjoying the culinary delights of a noodle restaurant. ď ľ

General Practice at Med School

University of Newcastle

University of Notre Dame Fremantle

University of Notre Dame Sydney

University of Queensland

University of Sydney

University of Tasmania

Amanda Fairweather gpsn.newcastle@gpra.org.au

Robert Hand gpsn.notredame@gpra.org.au

Mealear Sar gpsn.undsyd@gpra.org.au

Maelle Morgan gpsn.uq@gpra.org.au

Jacquelyn Choi gpsn.usyd@gpra.org.au

Bridget Hilliard gpsn.utas@gpra.org.au

What I like about General Practice: I like the idea of being able to care for the whole person, not just seeing them for an anonymous consult and then they seem to cease to exist, but getting to know them over time, meeting their family, being a part of their lives. And personally, the work-life balance is important. I really want to be a doctor – but there's more to life than being a doctor.

Most memorable med school experience: Watching a subdural haematoma being evacuated.

What I like about General Practice: The GPs I've met. They have all been people who practise medicine in the way that I hope to be practising when I graduate – with sincerity, passion, empathy and a knowledge of medicine that is not unlike other specialists.

Three words that describe me: Huge Lost fan.

Funniest med school moment: The first time I heard the words "I concur" from a Consultant.

Three words that describe me: Loyal, passionate, caring.

What I like about General Practice: General Practice is about variety, balance and flexibility.

Most memorable med school experience: Definitely my first year elective in Vietnam. That was an amazing experience and I don't think you truly understand the wonders of medicine until you've experienced medicine in a third world country.

Most memorable med school experience: Holding a human heart in cardiothoracic surgery. What GPSN means to me: GPSN means a chance to learn more about General Practice and change other people's misconceptions of an undervalued medical specialty. Best GPSN event: Our last skills night, which involved suturing.

Funniest med school moment: We have a well-meaning but sometimes confusing Pathology lecturer who has given us some brilliant metaphors over the years. Chronic inflammation: "It's like two kids in the back of a car when one hits the other, and he hits him back and they are both whacking each other and you turn around and smack one and smack the other and say 'shut up!'." 

General Practice at Med School

University of Western Australia

University of Western Sydney

University of Wollongong

Gemma Winkler gpsn.uwa@gpra.org.au

Nat Vo gpsn.westsyd@gpra.org.au

Shivani Verma gpsn.wollongong.gpra.org.au

Most memorable med school experience: It would probably be when I put my first cannula into a patient. She was an elderly lady and was about to go to surgery. I was so nervous and I was sure I was going to miss. I felt like my hand was shaking all over the place. I’m not sure how I got it into her vein, but somehow I did. I couldn't believe it!

Three words that describe me: Naughty, nice and nifty; they all start with ”n” and fit perfectly in front of Nat. Nifty Nat!

Most memorable med school experience: I have two: suturing at med camp and my clinical placement with my GP. He is so great and funny – he really makes our placements worthwhile and enjoyable.

What I like about General Practice: I love the diversity. Anyone who knows me will realise that I change my mind about what speciality I want to practise at least once a week. Then I realised that the perfect specialty for me would be one where I could combine many interests. General Practice is now at the top of my list.

Most memorable med school experience: So far this year I would have to say the most memorable experience would be organising the o-week med camp for the first years which ended on the Sunday, then straight away going to Canberra on the Monday for the BNL Conference. An extremely exhausting week, but totally worth the sleep deprivation.

What I like about General Practice: I love the fact you can specialise part-time in a sub-specialty if you wish and also choose your hours of work. Although a strong ambassador of GPSN, it's amazing how much I'm still learning about the qualities of General Practice. It ties together so, so, so many different specialties.

General Practice at Med School

A Year in the life of L PRACTICE STUDENTS NETWORK

GPSN

A GPRA initiative

Live well/study well workshop, University of Adelaide

Icebreaker, Griffith University

Clinical skills evening, Deakin University

Suture workshop, Griffith University

General Practice at Med School

GPSN Schwartz First Wave Scholarship Program APPLY NOW! GPSN has launched a prestigious new scholarship that gives first and second year med students early real-life exposure to General Practice. Are you in the first or second year of your medical degree? Would you like to experience what it’s like to work in General Practice while establishing professional relationships with dedicated doctors? Then think about applying for the GPSN Schwartz First Wave Scholarship Program.

Thank you to our founding benefactor

GPSN thanks the GPSN Schwartz First Wave Scholarship Program’s founding benefactor, Dr Jerry Schwartz of the Schwartz Foundation, for his support. We also acknowledge MDA National Insurance Pty Ltd for providing each student recipient with one year’s free professional indemnity insurance.

The program was initiated by General Practice Students Network (GPSN) to provide positive, early, structured exposure to General Practice, specifically in outer metropolitan and academic settings. The pilot program was successful and the scholarship is set to expand. The experience would be invaluable – and would certainly add some sparkle to your CV! What GPSN Schwartz First Wave Scholarship Program – GP exposure opportunities currently available at participating Australian universities. Why it began There was previously a lack of opportunities for first and second year medical students to gain real-world exposure to General Practice in an urban setting. There was also a desire by GPSN to raise awareness of General Practice and its role in health care. Who’s behind it GPSN, participating Australian medical schools, participating General Practices, Dr Jerry Schwartz of the Schwartz Foundation and MDA National.

How it works There are two streams – Clinical and Academic. Candidates apply via a formal process. Scholarship recipients are teamed with a General Practice Preceptor who mentors them. The experience principally involves working for a number of supervised sessions in a clinical practice (Clinical) or doing a research project or other academic activity (Academic). Academic scholarship winners will also do some clinical sessions. Scholarship activities are generally scheduled during the post-Christmas summer holidays. Who can apply First and second year students at participating Australian medical schools. Check whether yours is currently a participant in the scholarship program.

DO IT NOW Applications open in July. Refer to the GPSN website closer to the time for further information.

Contact:

W: www.gpsn.org.au E: firstwave@gpra.org.au T: 1300 131 198 A: GPSN Schwartz First Wave Scholarship Program General Practice Students Network National Office Level 4, 517 Flinders Lane Melbourne VIC 3001

“The experience would be invaluable – and would certainly add some sparkle to your CV!”

General Practice at Med School

“My GPSN Schwartz First Wave Scholarship experience”

Emily Jenkins

Emily Jenkins, now a third year medical student at Monash University, gives her personal take on the GPSN Schwartz First Wave Scholarship Program. The pre-clinical years of medical school are important years of learning and self-discovery that lay the foundations for long careers in the medical world. While no curriculum is perfect, many universities, including mine, are struggling to appropriately prioritise the various demands upon student time – and career guidance is left wanting. Adequate time must be allocated to considering the most important question of these early years. That question. That question that never goes unasked, whether it be by the Consultant you’re supposed to be shadowing for the afternoon (or the Intern you instead get palmed off onto), by the guy or girl you tried to make polite conversation with in the coffee line, by the long lost family friend who hasn’t seen you since you were “this big”, or worst of all, by your fellow meddies. Yes, that question. “So what type of doctor do you want to be?”

Sexiness scale

Medical polygamist

Orientation workshop

I think it’s fairly true to say that General Practice has a little bit of an image problem. On the specialty sexiness scale it sits somewhere between Radiology and deregistered practice nurse.

However, one thing I gradually came to realise as I matured into a marginally wiser second year student was that I could not really see myself in many of the career options I had been throwing around in my head. When it came down to it I just didn’t want to commit myself to one tiny little area of medicine.

With this budding interest I naturally jumped at the chance to be involved with the GPSN Schwartz First Wave Scholarship Program as an opportunity to further my understanding of General Practice. I was lucky enough to be selected and in September 2009 headed up to Sydney for an orientation workshop.

This wasn’t a matter of falling out of love with any of the various “ologies” I had now been introduced to, rather I wanted to marry them all: a medical polygamist that would be able to do a little bit of everything. But equally importantly, I didn’t want my experience of medicine to only show me what could go wrong; I wanted to be involved in sickness but also in health. In essence, I wanted to work with people, not with illnesses. And so the seed of General Practice was planted.

This was an intensive weekend of inspirational guest lecturers, GP “mythbusting”, personal experiences of current GPs and GP Registrars during the training process and in practice, and an introduction to the scholarship itself. I found this to be a very positive experience.

But what is perhaps the greatest shame about all this is that if med students regard General Practice as a specialty at all, it’s very much as a second-rate one – a tier below the standing of other “proper” specialties. Coming from an emphatically non-medical background I think I was particularly susceptible for this mentality and the surreptitious pressure that exists to aim for what the masses deem to be the highest echelons of medicine. So along with my peers I spent my first year of medical school falling madly in love with whatever specialty had featured in the preceding lecture.

It was very refreshing to be in a forum in which General Practice was not seen as a second-rate option, but instead was embraced and promoted. 

General Practice at Med School

“What I loved was that there really was no ‘typical’ day or ‘typical’ patient.”

Placement Back in Melbourne I was placed with GP Registrar Dr Mark O’Meadhra at Rowville Health, which thanks to my trusty GPS I discovered to be a large multidisciplinary clinic located in the south-eastern suburbs of Melbourne. My key objective for the placement was to get a sense of what General Practice was really like and Mark kindly consented to put up with me for a solid week so that I could try and achieve this. Reflecting back over my placement now, what really stands out is the variety. I spent the majority of each day sitting in on Mark’s consultations, but far from the steady stream of coughs and colds I was expecting, I saw everything from broken bones to blood pressure checks, slapped cheek to suspicious lumps, contraception advice to chest pain. Several consultations would have been ideal for a “dealing with emotion” OSCE.

Tricks of the trade One patient came in so unwell he was immediately sent to hospital, others were simply 50

there for routine immunisations. Consultations could be as short as a script renewal, or have a detailed history and examination necessary with a complex presenting complaint. What I loved was that there really was no “typical” day or “typical” patient. Simply watching Mark in action was an incredible learning opportunity – not just to see his competency when questioning or examining patients, but also to pick up on all the tricks of the trade which only come with experience, and the many subtle nuances of non-verbal communication.

Clinical exposure Opportunities for clinical exposure – especially quality patient time – in pre-clinical years are few and far between, so the clinical side to the placement proved an invaluable learning experience. With so many musculoskeletal injuries presenting, I could really consolidate these examination skills. Mark also had me listening to chests and taking blood pressure at every chance. Even more

excitingly, I was able to do some cryotherapy, syringe out a few ears and inject the local anesthetic and suture up after a skin tag excision. A further added bonus was the opportunity to spend time with several of the other health care professionals working at Rowville Health, and experience an efficient and effective team approach to health care provision. This included spending time in the mole clinic, with a physiotherapist and a chiropractor.

Inspiration What my placement highlighted to me was the variety, lifestyle flexibility and continuity of relationships with patients offered by General Practice. I immensely enjoyed my time at Rowville Health, and found it enormously inspiring to have the opportunity to be mentored by such an enthusiastic and passionate doctor. Was my placement what I was expecting? Not really. It was better! This experience has got me pretty hooked. And as for that question? I feel I can finally answer it with confidence. I want to be a GP.

“

I wanted to work hard in my job but be able to sleep in my own bed, not overnight at the hospital or do on-call or 80-hour weeks.

”

Dr Shannon Barry

Contributed by Emily Jenkins

General Practice at Med School

Other scholarships for med students THEREâ&#x20AC;&#x2122;S A SMORGASBORD OF SCHOLARSHIPS AND BURSARIES OUT THERE TO BROADEN YOUR EXPERIENCE, BOOST YOUR BANK BALANCE AND MAKE YOUR CV LOOK SHARP. PLEASE NOTE THIS LIST IS BY NO MEANS EXHAUSTIVE AS IT DOES NOT INCLUDE STATE-BASED SCHOLARSHIPS.

General Practice at Med School

General scholarships Avant Mutual Group and AMSA Medical Student Bursary Scheme AVANT, in collaboration with AMSA, is pleased to provide medical students with the opportunity to secure a $2,000 research fellowship in 2010. The fellowship is open to all Avant members. (NB: If you are not a member of Avant, you can join at no cost by calling 1800 128 268, via email at memberservices@avant.org.au or via their website www.avant. org.au). To apply for the fellowship, download the application form from www.amsa.org.au/ content/amsa-avant-researchbursaries and send completed forms with an outline of your proposal and the other necessary supporting documentation to PO Box 6099 Kingston ACT 2604 or mail@amsa.org.au Winners will be announced at the AMSA 2010 convention in Hobart, as well as on the Avant and AMSA websites.

Australian Defence Force Medical Scholarships

AMSA MIGA Student Elective Grants Program

The Australian Defence Force (ADF) sponsors students who are interested in pursuing a medical career in the Navy, Army or Air Force.

AMSA and Medical Insurance Group Australia (MIGA) award grants to medical students who are interested in completing an elective in developing communities overseas or in Australia.

The ADF covers costs involved in completing a medical education including HECS fees, student union fees, textbook costs, a rental allowance, and full medical and dental treatment. Students are also paid a salary with superannuation included. Graduates are required to serve as a Medical Officer for the number of years they were sponsored plus an extra year. To look for positions, visit www.defencejobs.gov.au For more information, call the ADF on 13 19 01.

Applications are open all year.

The program offers up to five opportunities, each consisting of a $2,000 elective grant to assist in meeting travel costs and a $1,500 medical support grant to assist in the purchase of medical or other aid for the community the student visits. The 2010 program is open to current medical students in Australia who are student members of MIGA and wish to undertake an elective program in a developing community between March 2010 and February 2011. Further information and an application form is available at www.miga. com.au or from MIGA on 1800 777 156.

Applications open on 3 May 2010 and close at 5pm (CST) on 27 August 2010.

Indigenous scholarships Puggy Hunter Memorial Scholarship Scheme The Puggy Hunter Memorial Scholarship is awarded to Aboriginal and Torres Strait Islander people who wish to undertake a medical degree or other allied health degrees. The scheme was created to boost the number of indigenous people in Australian professional health positions. As a full-time student, successful applicants receive assistance valued at up to $15,000 per year for the duration of their course. If the applicant chooses to complete their course part-time, they will receive assistance up to the value of $7,500 per year for the duration of their course. Information can be found on www.rcna.org.au or you can contact the Royal College of Nursing Australia (RCNA) on 1800 688 628.

Applications for 2011 are due to open mid-2010. ď ľ

Applications close on 31 May 2010.

General Practice at Med School

Australian Medical Association (AMA) Indigenous Peoples’ Medical Scholarship The Australian Medical Association also offers scholarships to indigenous Australians who wish to study medicine. Students who are currently enrolled full-time at an Australian medical school and have successfully completed at least their first year in medicine are eligible to receive the scholarship. Applicants must also be eligible for ABSTUDY. For scholarships rewarded in 2010, students will receive up to $9,000 worth of assistance for every year of their degree. More information can be found on the AMA website www.ama.com.au

Applications for 2011 open in November 2010 and close at the end of January 2011.

Rural scholarships John Flynn Placement Program (JFPP) The John Flynn Placement Program offers medical students the opportunity to experience General Practice in a rural community, spending eight weeks over a number of years (usually two weeks a year over a four-year period).

General Practice at Med School

AMSA NRHN Rural Elective Bursaries

Cotton Industry Medical Scholarship

AMSA and the National Rural Health Network (NRHN) offer Rural Elective Bursaries to allied health and nursing students who wish to complete an elective in Indigenous and Remote Health.

The Gwydir Valley Cotton Growers Association offers scholarships to students who are interested in rural medical practice. The grant is for three years, with a total of $15,000 being awarded to the successful applicant to assist them in completing their rural placement.

The scholarship covers travel and accommodation costs. Students are also provided with $500 a week during the placement to cover food and living expenses.

One Rural Elective Bursary is awarded to a medical student every year. The bursary is valued at $1,000 and assists students with the cost of planning and undertaking the elective.

Students are matched with an experienced rural doctor in the same community each year and are expected to finish the entire eight weeks by the last holiday period following completion of their medical course.

For queries regarding the bursary, contact the AMSA Rural and Indigenous Officer at rural@amsa.org.au or the NRHN at nrhn@nrhn.org.au Information can also be found at www.amsa.org.au

The Australian College of Rural and Remote Medicine (ACRRM) administers the program on behalf of the Australian Government. For further information, contact the JFPP Program Coordinator or the Support Officer at ACRRM on 1800 231 231 or email jfpp@acrrm.org.au

Application dates for 2011 will open in mid-May 2010.

To apply, students must be an Australian or New Zealand citizen or a permanent resident of Australia and currently studying at an Australian medical school. They must be either enrolled in their second year of a postgraduate medical degree, third year of a five-year medical degree or fourth year of a six-year medical degree. The NSW Rural Doctors Network is the administering agency and information regarding the scholarship can be found at www.nswrdn.com.au or contact Marie Kelliher at students@nswrdn.com.au

Applications for 2010 close on 9 April 2010.

Rural Australia Medical Undergraduate Scholarship (RAMUS) Scheme The RAMUS Scheme aims to give students from rural areas the same opportunities in medicine as their urban counterparts. It provides students from rural areas with financial assistance while they complete their medical degree. Australian citizens or permanent residents are eligible to apply for a RAMUS scholarship. They must have lived in a defined rural area in Australia for a minimum of five consecutive years or eight cumulative years from their fifth birthday up until they entered medical school. Each scholarship is worth around $10,000 per annum. Every year approximately 100 new scholarships are made available for students. For further information, visit the National Rural Health Alliance (NRHA) at www.ruralhealth.org.au or call 1800 460 440.

Applications for 2011 open in early November 2010 and close in January 2011.

Medical Rural Bonded Scholarships The Medical Rural Bonded (MRB) Scholarships are offered as part of the Australian Government’s Rural Health Strategy, which aims to provide improved medical services to rural and regional communities. 100 scholarships are offered annually worth over $23,000 a year each. Students must commit to working six continuous years in rural or remote Australia after they complete their medical training. Students must also express an interest in obtaining an MRBS place with the university in which they have been accepted to complete their medical degree. For further information regarding the application process, please contact the medical schools directly as they invite expressions of interest in different ways. Information can be found at www.health. gov.au/mrbscholarships or you can call 1800 248 720 or email MRBscholarships@health.gov.au

The next round of applications will open and close early in 2011. (Applications are normally between February and April.) 54

General Practice at Med School

5 top tips to make your GP rotation count How do you get the most out of doing prac in a General Practice? These tips will help.

Be positive. Approach your General Practice rotation in a positive manner and seek to make the most of all learning opportunities.

Define your interests. Prior to commencing your rotation, give some thought to your interest areas in General Practice and your specific personal learning objectives.

Talk to your teacher. Meet with your GP clinical teacher at the start of the placement to discuss and formulate key learning objectives for the rotation with the intention of reviewing these later.

Meet and greet. Actively participate in orientation to the practice by meeting all the staff and understanding their roles.

Learn about admin. Seek to understand administrative processes within the practice including billing and referral systems. And donâ&#x20AC;&#x2122;t forget to have fun!

Contributed by Amit Vohra and Jan Walker

After med school,

WHAT NEXT? Almost finished uni and planning your internship? Hereâ&#x20AC;&#x2122;s how to keep your options open for a General Practice career while doing your hospital training.

After Med School, What Next?

THINK like a GP in hospital

Preparing for your internship? There are ways to keep your career sharply focused on General Practice during your hospital training. Once you begin your hospital training, there is often little time left to think about how your hospital experience may be able to advance your future career path as a GP. Here are a few points to help you make the most of your hospital experience. Fine-tune your practical skills. Ask nurses to teach you skills that will be needed in General Practice that you may not have been required to do as a Resident; for example, giving vaccinations (especially to children) and dressing wounds.

Pick up useful procedural skills. Learn procedural skills that may be useful in General Practice; for example, joint injections. Learn the art of referrals. Discuss the referral process with Consultants. What do they like in a referral? What tests should be ordered prior to referral? How urgently do they need to see particular cases? Focus on the information that matters. Think about what information is pertinent on a referral letter sent with a patient to Emergency.

Practise your writing. Take particular notice of writing comprehensive and prompt discharge summaries, and don’t be afraid to call GPs to tell them their patients are coming home. Find out who’s who. Identify people who may be good information sources when you are working in the community; for example, Hospital Registrars and Consultants.

Contributed by Dr Kate Beardmore

Join the Going Places GP Network in your hospital The Going Places GP Network is a new organisation for junior doctors and is the hospital-based equivalent of GPSN. The Going Places GP Network presents professional development events, social activities and a magazine with a General Practice focus but is open to all prevocational doctors, not just those who have already decided on a General Practice career. Be part of it as it continues to roll out to teaching hospitals across Australia. For more information, visit www.gpaustralia.org.au, email goingplaces@gpra.org.au or phone 1300 131 198. 58

Choose the right hospital and rotations Choose a hospital and terms that will give you experience with common GP-managed conditions. During hospital training there are rotations and experiences that are considered to be mandatory preparation for the Australian General Practice Training (AGPT) program. There are four compulsory rotations: Internal Medicine (preferably General Medicine but as this is not available in some hospitals, a rotation that offers broad medical experience) Surgery Accident and Emergency Paediatrics In addition to these rotations, FACRRM requires Registrars to complete rotations in Obstetrics and Gynaecology, and Anaesthetics; and FRACGP requires Registrars to obtain hospital experience in at least three other areas. If you have completed some of these as a prevocational doctor, you may be qualify for Recognition of Prior Learning (RPL) so you can either reduce your training time or substitute part of your training developing existing skills or new skills. Your Regional Training Provider (RTP) can provide further information about how to apply for RPL, which you must apply for in the first year of training. RPL may be approved for all, or part, of the requirements of the post-internship hospital year of training. It is also a good idea to do some of your training in a General Practice if your hospital is part of the Prevocational General Practice Placements Program (PGPPP). (For more information about the PGPPP, see page 60.)

After Med School, What Next?

PGPPP

Try it on for size

If you’re wondering whether General Practice is the right fit for you then give the Prevocational General Practice Placements Program (PGPPP) a go. The PGPPP – the Prevocational General Practice Placements Program – is a great way to experience General Practice during your hospital training years.

of respected GPs. The experience strengthens understanding of the integration between primary and secondary health care and offers a broad view of Australia's health system.

Whether you’re seriously considering a GP career or you simply want to gain a deeper insight into primary care, it’s an experience that will enhance your medical training.

Who is eligible?

Work in a community General Practice Work as a valued colleague in a city or country practice, live in the community and experience a real change of pace from the hospital setting.

Benefits for junior doctors Junior doctors gain real-life experience in General Practice over and above that of undergraduate training. By seeing their own patients in a supported environment, confidence and independence grows under the guidance

The PGPPP is open to Interns and Postgraduate Year 2/3 doctors. Terms are generally equal in duration to hospital rotations. You will be well supported with defined levels of teaching and supervision in an accredited training practice.

A seamless move The PGPPP funds educational resources, travel and accommodation (conditions apply). All salaries continue to be paid while on placement, and superannuation, indemnity and industrial arrangements are managed by the hospital of origin, to ensure a seamless move from hospital to practice.

FACT FILE When you begin your internship, talk to your Medical Education Officer or Director of Clinical Training about the PGPPP. Or visit www.agpt.com.au and go to ‘Prevocational Training’.

“Work as a valued colleague in a city or country practice, live in the community and experience a real change of pace from the hospital setting.”

“

What I love about General Practice is the continuity of care and relationships formed with patients and families.

”

Dr Carly Taylor

After Med School, What Next?

“My PGPPP experience” Dr Rhutam (Raj) Mehta AS A JUNIOR DOCTOR, DR RHUTAM (RAJ) MEHTA FOUND THE BEST WAY TO EXPERIENCE GENERAL PRACTICE AND GAIN CONFIDENCE AS A DOCTOR WAS TO SEE HIS OWN PATIENTS AT A PRIVATE GP PRACTICE. Where did you do your PGPPP?

What was your experience like?

I did the PGPPP as part of my PGY2 at Royal Perth Hospital. My placement was at Stirk Medical Centre in Kalamunda, a suburb in the Perth Hills.

Let me honestly say that the best way to experience General Practice is to fully immerse yourself in it. Within a week I was given my own room, complete with name plate, and started seeing patients on my own. At first this was quite daunting, however I was particularly impressed with the promptness of my GP mentors who would rush to my aid whenever I had a question regarding patient management.

How did you feel about doing the PGPPP at first? Initially, I had my doubts about whether I had made a good choice. My colleagues were about to start the Community Residency Program, which includes some hospital contact as well. I was about to start a solely GP-based program.

How did your GP placement compare with hospital work? I really enjoyed the direct contribution I was able to make to people's health care. Often, in the hospital system as a junior doctor, a lot of time is spent doing "tasks" for the team.

“Signing up for the PGPPP was an excellent learning experience both in terms of my future career planning as well as furthering my RMO education. I would strongly recommend it.”

FACT FILE When you begin your internship, talk to your Medical Education Officer or Director of Clinical Training about the PGPPP. Or visit www.agpt.com.au and go to ‘Prevocational Training’.

What range of work did you actually do? I was performing procedures from the excision of moles to the drainage of a knee to relieve pain. It was also very satisfying be the first point of care and to see some true pathology that

had not already been managed to some extent by others. All this meant that I felt I really was making a difference.

Program highlights? The interaction with children. The kids I saw at my practice generally presented with welldefined clinical problems and I was able to help my little patients as well as reassure their parents.

What advice would you give other junior doctors about the PGPPP? Signing up for the PGPPP was an excellent learning experience both in terms of my future career planning as well as furthering my RMO education. I would strongly recommend it.

Get published in the GPSN e-newsletter and win a $50 Myer voucher!

4 Design your own

CAREER AS A GP

A story to tell? A photo to share? GPSN invites you to contribute the

General Practice is all about diversity. You can explore

following content for our monthly e-newsletter:

an almost endless range of sub-specialties during

* A funny story about medical school.

training and practice. Whatever your interests, you can

* A short article about a General Practice placement or experience.

design your career around them in General Practice.

* A short piece of poetry or prose with a medical theme. * A photograph that reflects General Practice â&#x20AC;&#x201C; a typical clinical setting or a location that General Practice has taken you. The best entries each month will receive a $50 Myer gift card and be published in the GPSN e-newsletter. Submission All articles must be 350 words or less and content must be submitted in a Word document or JPEG file for photographs. Deadline 1st of each month. Contact Kristen Tee (Publications Officer) at enquiries@gpra.org.au

GENERAL PRACTICE STUDENTS NETWORK

A joint initiative of GPRA and AMSA

Design your own career as a GP

WHAT KIND OF

will you be?

No other specialty offers so many special interests to pursue during training and practice. These are just a few of the options. Aboriginal Health Academic Medicine and Research Anaesthetics Antarctic Medicine Australian Defence Force Aviation Medicine Cosmetic Medicine Dermatology Drug and Alcohol Emergency Expedition Medicine Family Planning and Sexual Health Forensic Medicine Geriatrics HIV Medicine Menâ&#x20AC;&#x2122;s Health Mental Health Musculoskeletal Medicine Obstetrics Occupational Medicine Paediatrics Palliative Care Royal Flying Doctor Service Sports Medicine Surgery Travel Medicine Tropical Medicine Womenâ&#x20AC;&#x2122;s Health Plus many more 66

Design your own career as a GP

Your career your way Sports Medicine GP training encourages Registrars to explore the many guises of General Practice through various stimulating side trips. Many, like this trio, find their passion.

Aboriginal Health Dr Jenny Lonergan

Dr Michael McLean

boriginal Health is part of the training program for GP Registrars. Most say it’s one of the best things they’ve ever done – and for many there’s the boomerang effect.

“My involvement in Sports Medicine means getting out of the practice setting and being involved with local sport and games, from rugby league to hockey to soccer to cricket and others, usually on weekends.

Dr Jenny Lonergan was one such Registrar. While training, she spent a term at Redfern’s Aboriginal Medical Service and loved it.

Working at the AMS means an involvement in the local community – something Jenny regards as a privilege.

“When I left, the staff gave me a purple boomerang so I’d come back. So I did, and I’ve been there for six years now.” 68

“Most of my patients have a really dry sense of humour. Aboriginal people are quite resilient and they don’t tend to come in and see you unless they’re really unwell, so you do get a sense that you’re making a real difference to their health,” she says.

r Michael McLean is a GP Registrar working in Bundaberg in Queensland and also the team doctor for the Australian schoolboys rugby union team.

He began his working life as a physiotherapist then enrolled in medicine in his late 30s. He is currently completing a Masters in Sports Medicine.

“When I left, the staff gave me a purple boomerang so I’d come back. So I did, and I’ve been there for six years now.”

“I see the athletes when they’re participating, and attend to them on the spot if they’re injured.

“Treating acute injury on the field, as it happens, is very different to an Emergency Department. Some injuries are dealt with on the field, but others need the protection of a safe medical environment – like a first-time dislocated patella.” By blending his allied health skills with his newlywon General Practice ones, Michael has found his true calling. 

Design your own career as a GP

Rural Dr Scott Finlay

utures broking is a long way from rural medicine but Dr Scott Finlay has no regrets. After working for a large bank on Sydney’s North Shore, he became disillusioned with the world of finance and decided to pursue his childhood dream of becoming a doctor. After his second rural placement he was hooked on General Practice, and rural General Practice in particular. He currently works in Moree, and combines private consulting with on-call work at Moree Hospital.

“Over the last week, I’ve done some General Practice consulting, I’ve given general anaesthetics, delivered a baby, had inpatients at the hospital to look after...”

“There’s no such thing as a typical week,” he says. “Over the last week, I’ve done some General Practice consulting, I’ve given general anaesthetics, delivered a baby, had inpatients at the hospital to look after and, on Friday, I drove down to Narrabri Hospital to help out with a major motor vehicle accident involving 10 patients. “A GP mentor of mine made me realise that being a good rural GP meant having the ability to walk into any situation and offer some help – being present and effective.

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Design your own career as a GP

academic life

Design your own career as a GP

This

“You should have the opportunity to get involved in the academic life of the university you are based at.”

Have you ever considered being… A media GP?

Teaching and research can expand your career path in General Practice. I love being a GP Registrar. I love seeing patients – hearing their stories and learning from them. But every now and then, I crave something a little bit different – something that challenges me on a different level. That is why I have chosen to do an Academic Post as part of my training.

What is an Academic Post? Basically, an Academic Post is an opportunity to spend a term of your General Practice training involved in research and teaching. Registrars are usually supervised by a university’s Department of General Practice, or a rural clinical school. You should have the opportunity to get involved in the academic life of the university you are based at. This could mean attending meetings, sitting on curriculum committees, or just talking to other people about the research they are doing. You will also get to be involved in the teaching activities of the department and to work on a research project of your own. You will 72

also be required to continue doing some clinical work during this time.

Why do an Academic Term? You can choose what you want to research, so you can be involved in something that fascinates you. Over six months, you can potentially start to develop some research that is really groundbreaking and exciting – you might even get published. It gives you flexible work hours. It gives you variety in your days and a break from the demands of clinical work. It encourages you to develop a different and valuable skill set. It gives you a “foot in the door” to the world of Academic General Practice. It encourages you to think about best practice and evidence-based medicine. You will be involved in the teaching and examination of medical students, which is invaluable for your own exam preparation.

Could you be the next Dr Norman Swan or Dr Cindy Pan? There are opportunities out there for GPs with great communication skills who can explain complex medical topics in soundbites the average person can understand.

A medical editor or journalist?

Consider a training post with Australian Family Physician where you can develop your writing and editing skills for the medical media. In addition to lecturing, teaching and research, there are a number of other ways to combine General Practice with the world of education, media and communication.

The best thing about Academic General Practice for me? It makes me feel like I can be a better doctor for my patients. And I know that by combining teaching and research with my clinical work I will always feel energised by a career that offers me something different every day.

Contributed by Dr Adrienne Burchard with Dr Rachel Lee

You will get to meet some amazing, inspiring people, both medical and non-medical. 73

Design your own career as a GP

Travel

while you

train

Real-lifeAllocation 7 Term 5

Strap on your backpack and make the world your consulting room while you train. It’s all possible in General Practice. If you enjoy travelling and are keen to gain clinical experience from another country, RACGP offers a great opportunity to complete part of your General Practice training, including Extended Skills or Advanced Skills Terms, overseas. Typically, these are a six-month full-time position, although part-time can also be arranged. Overseas terms have been completed in many locations including the United Kingdom, Ireland, USA, New Zealand, China, Malaysia and the Middle East (Australian Defence Force posts).

Following completion of the post you are required to submit a report to the RACGP of the experience and learning undertaken. The ACRRM curriculum also allows for overseas training posts. The overseas terms are a fantastic opportunity to broaden your horizons while completing your General Practice training.

ANDADVENTURES CHOICE GP

Practice Share theplacements, real-life stories jobofinter GP Registrars views andwho even have the odd problem GPland’s explored need notwell-worn be ner ve-wracking paths and roads whenless you travelled. know

FACT FILE For further information regarding RACGP overseas training posts, visit www.racgp.org.au There are also overseas training posts available when training to the ACRRM curriculum, visit www.acrrm.org.au Registrars should talk to their RTP about what “travel while you train” opportunities they may be able to offer.

what to expect and what approach to take.

Real-life GP adventures

Luck of the

My income was a salary paid in Australian dollars, which was unfortunate given the exchange rate at the time. Sadly, the recession had not yet hit Irish food prices.

Teaching and learning Dr Kelly seach experienced the Celtic charm of rural Ireland on her overseas training post.

o you like Guinness? Celtic crosses? Irish accents? Then perhaps you should consider doing what I did, and apply for the GP Registrar exchange program between Gippsland Education and Training for General Practice (getGP) and the Donegal GP Training Scheme in Ireland. And don’t let a long-haul flight with a toddler, the Irish winter, or entering your third trimester of pregnancy stop you. At least I didn’t.

Picturesque County Donegal I worked in General Practice for a couple of months in the town of Ballybofey in County Donegal, in the picturesque north-west of Ireland. My partner put paid work on hold and became the full-time carer of our daughter. I think we each thought we had the better deal. Ballybofey and its “twin town” Stranorlar are divided by the river Finn, and famous for salmon fishing. Donegal is adjacent to Northern Ireland, and has an interesting history in addition to being wet, rugged and spectacular in its geography.

The economic boom of the Celtic Tiger had drawn to a close and the recession had hit hard where I was working, with unemployment high and lots of unfinished construction in an area that was already one of socio-economic disadvantage.

“Quirks included calling the patients using a push-button system over a loudspeaker. It seemed a bit too much like a fish and chip shop to me.” Salary The Health Services Executive (HSE) administers the financing of health care in Ireland. Means testing divides the population into General Medical Scheme (GMS) and private patients. The former receive a medical card which entitles them to unlimited GP consultations and medication free of charge; the latter pay for both. Thus GPs’ incomes are a mixture of capitation and fee for service.

With GP training in Ireland there is a full day each week devoted to teaching and learning outside the practice environment, as well as tutorials in the clinic. The quality of the teaching was excellent, and I was particularly impressed with the peer-to-peer teaching.

FACT FILE The Irish exchange program is regularly offered through getGP and may also be arranged through some other RTPs.

New ways of working Working in a new health system took a bit of getting used to. Patient presentations were, of course, similar to home, but I did come to realise how much is shaped by financing, resources and culture. Home visits are much more common than I was used to. Out-of-hours care is provided through a co-operative, servicing a large region. A lack of trained paramedics means a lot of doctors’ time can be spent attending patients outside the surgery.

Bemused looks Quirks included calling the patients using a push-button system over a loudspeaker. It seemed a bit too much like a fish and chip shop to me. 

“Needless to say, the Irish are a sociable and hospitable lot, from providing play dates for my partner and daughter to after-work dinner and drinks…” 77

Real-life GP adventures

I endured the bemused looks of staff and colleagues and continued to walk the corridor to call each patient in person.

drinks, and culminating in a graduation party for the 2009 cohort in a “barn” belonging to one of the trainers.

Other differences included not having access to imaging (resulting in a lot more referrals to Consultants or Emergency than at home), “pathology collectors” not existing (nurses or doctors take all the bloods), and the astounding presence of a dot-matrix printer in my consulting room to generate both scripts and letters. The 9.30am starts were definitely a bonus.

Campervan touring

Dinner and drinks

In all, I loved my Irish exchange. Why not try your Irish luck and give it a go?

Needless to say, the Irish are a sociable and hospitable lot, from providing play dates for my partner and daughter to after-work dinner and

Three weeks touring Ireland in a campervan as the first flush of spring crept across the country rounded out our stay. My daughter had seen her first snow and learned to enjoy Sesame Street in Irish. My partner had refined his photography and campervan driving skills. I learned how to pronounce Irish names, appreciate potatoes five ways and work in a different health care system.

Contributed by Dr Kelly Seach

Real-life GP adventures

Doctor ON ICE Fancy being the lone doctor in an icy, remote camp of international scientists ON THE GREENLANDIC ICE SHEET? Dr Lizzie Elliott tried it – and loved it. Waking up in a tent at sub-degree temperatures might not be the average GP’s cup of tea. To be honest, the idea did not appeal to me, but I was far too distracted about the challenge of working as a doctor in such an extreme location as the Greenlandic ice sheet to worry about ice crystals on my sleeping bag. As a final year student, I undertook a General Practice elective in Copenhagen, Denmark. Little did I know that three years down the track I would be working with the Danish University on the Greenlandic ice sheet as a Field Medical Officer. I have completed two stints now of three and sixweek placements and am keen to return for more.

Climatic research North Greenland Eemian Ice Drilling (NEEM) is a semi-permanent camp (2007-2011) set in the central North Greenlandic ice sheet with the 80

aim of drilling the ice core to bedrock (around 3,000 metres), allowing analysis of the ice for climatic research. It is a collaborative effort that runs during the Northern Hemisphere summer. Countries assisting the Danes are Australia, Belgium, France, Germany, Holland, Iceland, Norway, Sweden, Switzerland, UK, China, Japan, South Korea, Canada and USA. All NEEM participants undertake a similar medical check to Antarctic medicals so everyone is in good health prior to departure, and dental extractions and appendectomies are not obligatory. There can be up to 36 people living in camp – scientists, electricians, carpenters, plumbers, mechanics, cooks, mountaineers and a doctor.

Communal living There is a communal living and eating “dome”, three storeys high, where everyone gathers for

set meal times and R&R with movie nights, a soccer table and internet hub. The other means of communication is a satellite phone. People sleep in heated Weather-port tents and unheated tents, with larger Weather-ports acting as garages and a workshop. This year saw the addition of a new sauna and table tennis table in camp, which boosted morale, and many new ping-pong games were invented. Despite all the fun and games there was serious scientific work under way such as firn-gas pumping, seismic recording, radar layer assessment, shallow ice coring and deep ice coring with on-site processing.

Personnel rotation The main transport to NEEM is via ski-equipped Hercules aircraft manned by the US Air Force. On site there are skidoos, tractors and a tread-

modified 4WD Toyota for speedy movement around the camp and transport of heavy items. Rotation of camp personnel occurs every three weeks or so via Hercules, when food, building materials and medical supplies are also restocked. With the changeover of doctors there are often a few hours while the plane is unloading and reloading for a medical handover.

Prince Frederik During my 2009 season I was in camp for the arrival of 20 distinguished visitors (DVs) and media, who bring greater attention to climate issues by reporting on the scientific research at NEEM. To my knowledge, none of these people had been medically screened prior to arrival so I spent the time close to the AED and oxygen apparatus! Earlier in the season NEEM was visited by HRH Prince Frederik of Denmark and the Prince and Princess of Sweden. 

“There can be up to 36 people living in camp – scientists, electricians, carpenters, plumbers, mechanics, cooks, mountaineers and a doctor.” 81

Real-life GP adventures

Unlike Antarctica, there is no prerequisite for surgical or anaesthetic experience (although it’s beneficial). This is because the site is not as isolated as Antarctica, and air retrievals can be arranged to the nearest air base two hours away. Fortunately, there were no emergencies, mainly superficial injuries, some dental concerns, many musculoskeletal complaints and counselling. Other roles undertaken by the doctor are OH&S officer with advice on safe lifting practices and sun protection as well as hands-on public health matters such as digging new long drops (toilets) and maintaining a clean water supply through the ice melter.

Polar bears Due to the open plan design of the dome, my work area consisted of a desk, where I kept all the medical supplies, and non-intimate assessments were conducted. Quite a few people in camp had done first aid training, which was reassuring to know in case of a medical emergency. Plus the drill site for the ice core was eight metres below the ice surface, which meant that the mountaineer could coordinate vertical retrieval if required. There was someone permanently on site who had access to a firearm should a polar bear wander into camp. This was unlikely due to NEEM’s distance from the coast. Phew! General Practice training has given me the ability to deal with my medical encounters 82

FACT FILE Registrars interested in Expedition Medicine should talk to their RTP about the options. GPTT in Tasmania has an Extended Skills Post in Expedition Medicine as well as a series of highly regarded, experiential short courses on different aspects of Expedition Medicine. CoastCityCountry offers an Expedition Skills Post in the ski fields. Visit www.ccctraining.org or www.gptt.com.au

on the ice, both physical and mental. The flexibility of the training and the suppor t of staff at General Practice Training Tasmania (GPTT) have been integral in my diverse GP experiences as a Registrar.

Expedition Medicine Applying for Expedition Medicine training as an adjunct to my RACGP training through GPTT and undertaking a week-long course at Freycinet gave me improved skills, greater knowledge and more confidence in dealing with extreme conditions and cold-related injuries (particularly as I grew up and trained in North Queensland).

“

Children are a delight to see in General Practice. They are entertaining, surprising and interesting patients.

”

Dr Rebecca Roach

I look forward to gaining more experience in extreme climates, with Antarctica a future working goal.

Contributed by Dr Lizzie Elliott 83

Real-life GP adventures

Diary of a

6.30am

Wake up to the squawk of cockatoos sitting on the power line outside my bedroom window. Better than any alarm clock I know.

6.45am

Yell at cockatoos to “shuddup!” Has the same effect as every other morning – none.

8.35am

Walk the 200 metres from my house to the hospital. No traffic jams here, no parking problems either. As I wander up I see old Trumby sitting on the front step patiently waiting. Had to remove some gidgee from a leg wound last week. Silly old bugger was out catching goats to supplement his diminishing income during the drought. Nasty stuff that gidgee – can get infected really easily.

Rural Doc

And thus starts my day.

GP-anaesthetist and Director of Ochre Recruitment, Dr Ross Lamplugh, shares a typical day in his life as a rural doc in the “back of Bourke”.

I stroll back to the Gecko Cafe for a bite. As I wander home, Trev catches me.

“Got a few up here waiting for you when you’re ready.”

“G’day, doc,” he starts. “Are you still on for a game tonight?”

The kid with the temp, the lady with a rash and Suzanne looking for a bit of reassurance are easily dealt with.

you told me about really works. You know, doc, I thought you had half a chance of fixin’ me leg, but didn’t expect you could help me catch goats. I’ll drop you in a bit of pork when I shoot me next pig.” I stop in at the hospital to see my inpatients: a three-year-old with gastro; Mike with epigastric pain after one too many – again; Ben whose unstable angina seems to have settled today; and Suzanne whose diabetic leg is finally improving. As usual, the nurses have it all sorted – a list of jobs for me and the coffee pot on.

9.00am

I stroll up to the surgery about 300 metres the other way. Old Cat Kendal is leaning on the front rail.

“Things not going so well, Trumby?”

“G’day, doc,” he says, the standard greeting from everyone in town.

“Not at all, doc – leg’s great. Just wanted to say thanks for those tips on catching goats. That hook

“G’day, Cat,” I return. “Come on in and wait inside, I’m sure the girls will have a pot of coffee on.”

“I enjoy the unpredictability of rural practice, from dealing with an infarct and motor vehicle accident to giving an emergency GA for a cord prolapse, all in the space of an hour.”

A procession of the normal, the weird and the delightfully wonderful traipse across my floor from 9 to 12.30. There is old Cat in for his flu shot. Young Tracy who’s trying hard to have her first child. And the regular visit from Aunt Beryl, the town gossip, who comes in more for the chat really.

12.30pm

I think the only reason I am on the local squash team is to make everyone else look good but it is a great night out followed by a few beers.

with me since the start and her kids babysit mine. The coffee keeps coming and today we have scones. Yes, really!

6.00pm

Cleaned up and on my way to squash. The nurses at the hospital know it’s squash night and the game should be finished by seven. Sure enough, at about 7.10 the phone rings.

“Sure, Trev, so long as I don’t get called up by the hospital.” Over lunch I get my first hospital call. I am on call today so have to manage pretty much whatever comes in. Sounds impressive, but with the other doctors in town ready to lend a hand and the telephone as my best friend there really is help whenever I need it. Funny thing about working in Bourke, everyone in the city thinks you’re mad so I have never had a specialist not bend over backwards to lend assistance when I ring. Luckily, I can deal with this one by phone.

However, just as I am about to leave, an old cocky, Hully, comes in after catching one of his fingers in a chain on his tractor. The finger is degloved but functional. It is salvageable so I call a plastic surgeon in Sydney who accepts the transfer. I go back to deliver the good news.

2.00pm

“Will I be back at work tomorrow?” Hully asks.

Back to the surgery. Much like a city surgery afternoon, but with a bit more pathology and a lot more coping skills. The banter in the surgery is fantastic. Gay has been

“No, they’ll probably keep you in till they are sure the graft’s taken.”  85

Real-life GP adventures

FACT FILE “No way! I’ve got the shearing team coming tomorrow so I need to be home.” I had done some plastic surgery in my surgical training, and thought that with a bit of advice from my friendly plastic surgeon I can probably do a graft on him in Bourke if really forced.

For more information about Rural Terms, Registrars should talk to their RTP.

10.10pm

I explain the procedure to him. “I’ll wrap you up and you’ll still have your right arm for shearing all week.”

I reckon I’ve finally earned that beer so I wander down to the Oxford to see if it’s still open, and the squash team is there. Gary looks up from wiping down the bar and greets me. “G’day, doc.”

Still, that isn’t good enough. “Look, doc, you’re not listening to me. I need to have this hand working tomorrow to shear. I can’t shear one-handed. I really just came to get you to take the finger off.”

I enjoy the unpredictability of rural practice, from dealing with an infarct and motor vehicle accident to giving an emergency GA for a cord prolapse, all in the space of an hour.

Given that the finger is salvageable – and probably would get near full function back – I argue for a long time.

Not looking forward to being on call tonight though – don’t really enjoy getting up in the middle of the night. Luckily, the nurses screen things and it only happens once in a blue moon.

Eventually Hully states: “If you don’t take my finger off I’m going to go home and chop it off myself!” The look in his eye convinces me he is fair dinkum. So after filling out the most longwinded consent form I can devise (I have a terrible feeling this could come back to haunt me) I amputate his finger.

“Eventually Hully states: ‘If you don’t take my finger off I’m going to go home and chop it off myself!’ The look in his eye convinces me he is fair dinkum.” 86

About two weeks later at the hospital, one of the nurses warns me that the chap whose finger I amputated is back to see me. I am more than a bit concerned, wondering whether he regrets his decision and wants to have a shot at me for doing it. I wander out the front. There he is, holding up his hand to show me the result of the amputation. “Shearing went really well,” he beamed. “I had no problems with the hand and it’s healed well. Good on ya, doc.”

Contributed by Dr Ross Lamplugh, Ochre Recruitment

What’s Important to You?

Live more... Junior doctors enjoy working in the NT for the Challenge, Adventure, Oppotunity and Diversity they experience there!

Challenge The Prevocational General Practice Placement Program in the NT challenges your clinical and communication skills and gives you the skills to be a more effective doctor in every setting! Medical cases are punctuated by chronic disease, cultural nuances, language barriers, dynamic human and medical resources and vast remote distances and you get to be in the hot seat while being supported by accredited medical supervisors.

Adventure Use one of your hospital rotations to spend up to 13 weeks in a remote Aboriginal community clinic in the NT. The hardest part will be deciding whether a remote Aboriginal desert or island community, or a regional centre will suit you best - let the adventure begin!

Opportunity Training in the Territory as a junior doctor gives you the flexibility, skills and opportunity to work in Indigenous and developing world health while making a real difference to Australia’s remote and Indigenous populations. Use the opportunity to open doors to your future.

Diversity...

Be spoilt for choice ... You deserve it!

www.ntg pe .org

www.gpaustralia.org.au

6 Money MATTERS As a GP or GP Registrar, you are well paid without the extreme hours of some other specialties â&#x20AC;&#x201C; check the salar y over view. Plus you may be able to claim Everything you've ever wanted to know about being a GP but were afraid to ask.

Produced with funding support from

extra government incentives while you train.

Money Matters

What you

can earn

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

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

GP Registrar salaries Full-time GP Registrars work a minimum of 38 hours a week. This includes education time and administration time. The actual hours of consulting (seeing patients) are usually between 27 and 33 hours a week. This can vary, especially in rural areas. Remuneration is really determined by how many patients are seen and whether there is bulk-billing or private billing. The GP Registrar can negotiate an hourly rate of pay and/ or a percentage of gross billings generated.

Minimum terms and conditions During the first two GP Terms (or ACRRM equivalent), GP Registrars are guaranteed minimum terms and conditions of employment as agreed by GPRA and the National General Practice Supervisors Association (NGPSA). For each stage of training, there is a minimum salary or hourly rate of pay or the Registrar is paid a minimum of 45% of gross billings (whichever is greater). 92

Improved income Changes to Medicare rebates have improved GP incomes. Once established, a GP Registrar may bill anywhere from about $100-$240 per hour of patient consulting. They would then be entitled to receive 45% of billings = $45-$108/hr = $1,215-$2,916/wk. As an employee, the GP Registrar is also entitled to 9% superannuation and four weeks paid annual leave.

Different remuneration systems Those GP Registrars who do on-call and hospital VMO work should earn a minimum of 55% of the hospital billings. Some Registrars work in salaried practice, especially ADF Registrars, those in Aboriginal Medical Services and some rural and remote hospitals that also provide GP services to the community. It is important to note that working in rural areas, doing procedural work and working as a hospital VMO tend to attract significantly higher incomes. However, even in urban areas GP Registrars often earn more than what is stipulated in the National Minimum Terms and Conditions (NMT&C) document. ď ľ

Training stage

Practice style % of billings paid

On-call

Average patient consultations (hours/week)

Hourly ($)

Weekly ($)

Annual ($)

N/A

28-30 hrs plus education time

$37

$1,262

$65,613

GP Term 1 (or equivalent)

Any

As per NMT&C

GP Term 2 (or equivalent)

Remote

Salaried hospital based Medical Officer, procedural work

1 in 2â&#x20AC;&#x2030;-3 days

60-80 hrs

N/A

$2,658

$138,216

GP Term 3 (or equivalent)

Rural

50% mix billing, hospital admitting rights, procedural work

1 in 6 days

28-30 hrs

$66

$2,670

$138,840

Locum (immediately after completing training)

Rural

60% mix billing, hospital admitting rights

N/A

38-40 hrs

$90

$3,600

$187,200

Established GP (busy practice)

Rural or urban

65% private billing, hospital admitting rights

N/A

45 hrs

$115

$5,175

$269,100

For GP Registrars and GPs practising in rural areas, incentive payments are available on top of a regular salary. (For more information, see page 96.)

“

You make a good living – not that of an interventional cardiologist – but you have a heck of a better lifestyle. You’re not in the hospital at 3am putting catheters in people.

”

Dr Stuart Anderson

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

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

Calculate your income online www.gpsn.org.au/gpearnings Our online GP Earnings Calculator allows you to estimate your individual earning potential based on the kind of GP you want to be.

Money Matters

incentive

Money Matters

payments

In addition to your salary, you can claim an array of other financial sweeteners as a GP Registrar.

hen working as a GP Registrar, there are a few financial incentives and reimbursements to be aware of. These government incentives encourage more GPs where they are most needed, such as rural, remote and outer metropolitan areas. More details are available via the GPRA website www.gpra.org.au

General Practice Rural Incentives Program (GPRIP) The new General Practice Rural Incentives Program (GPRIP) will commence from 1 July 2010. The program will provide a consistent set of incentive payments that applies on an equal basis for GPs and Registrars in rural locations. The scheme favours doctors who stay in rural and remote areas for the longest periods of time. If Registrars train in rural and remote locations, then stay on and practise there, they will earn larger incentives. The more remote the location, the greater the rewards. Incentives will be paid according to a sliding scale based on the Australian Standard Geographical Classification –

Remoteness Areas (ASGC-RA) category and the length of time in a rural location (see table on page 97).

Accommodation Each RTP will have different accommodation and relocation subsidies for GP Registrars undertaking rural training. This can include free accommodation, mortgage/ rent subsidy and some furnishings. Subsidies may be greater for the first years of General Practice training.

HECS Reimbursement Scheme The HECS Reimbursement Scheme applies to graduates who have graduated in 2000 or later only. Participants will have one fifth of their HECS fees reimbursed for each full-time year of medical 

ASGC-RA classification

Period of time (years) in a rural location 0.5

3 - 4

RA2

$2,500

$4,500

$7,500

$12,000

RA3

$4,000

$6,000

$8,000

$13,000

$18,000

RA4

$5,500

$8,000

$13,000

$18,000

$27,000

RA5

$8,000

$13,000

$18,000

$27,000

$47,000

training undertaken or service provided in areas with Remoteness Areas classifications RA2-5. This means that over five years of working or training in these areas you could have all of your HECS fees for the study of medicine reimbursed.

More Doctors for Outer Metropolitan Areas Program GP Registrars who have completed their training and are prepared to work in an outer metropolitan area for two years are eligible for payments up to $30,000. For those prepared to set up their own practice and stay for three years, there is a total of $40,000 available.

Medicare Plus Medicare Plus offers rural and remote Registrars (and Tasmanians and those in areas of medical need) the opportunity to use item number 10991 instead of item number 10990 to receive a greater rebate. Registrars can ask their practice manager for further details.

FACT FILE Registrars should ask their RTP about the financial incentives they may be able to claim in addition to their salary or visit www.gpra.org.au

Contributed by Dr Stuart Anderson, Dr Siew-Lee Thoo, Dr Luke McLindon and Dr Tim Francis

7 Keeping

YOUR BALANCE General Practice gives you the flexibility to balance your personal life with your working life. Par t-time training? Parental leave? Family-friendly hours? Itâ&#x20AC;&#x2122;s all possible in General Practice more than any other specialty.

GENERAL PRACTICE STUDENTS NETWORK

A joint initiative of GPRA and AMSA

Keeping your balance

Part-time, smart time

Want to combine your vocational training with family life or other pursuits? It’s all possible with the very attractive part-time training options in General Practice.

he flexibility of General Practice when it comes to working hours is one of the reasons many people choose it as their career path. The training program has the same flexibility. Registrars who are unable to engage in full-time training may apply to do their training part-time. Part-time training can be applied for at any stage.

100

Although the hospital year is normally undertaken full-time, other components of training may be undertaken on a parttime basis. The details of each Registrar’s part-time training schedule are worked out with their RTP to ensure compliance with the AGPT program.

DO IT NOW Registrars should talk to their RTP about part-time training opportunities or visit www.agpt.com.au for more information.

Keeping your balance

Being resilient Learning to look after yourself is as important as being able to look after your patients, yet it is a skill that is usually not taught. Burnout is an important issue in the medical community. Research has shown that over 50% of Australian GPs have considered leaving General Practice at some time because of stress. Our profession generally entails more than a “9-to-5” job, with long hours, weekend work and on-call the norm. Added to this are increased organisational, financial and legal pressures in the medical professional environment. Doctors tend to be perfectionists, and our selection and training encourages us to be 102

conscientious, reluctant to delegate and unwilling to take time off when unwell. Registrars have additional sources of pressure, often juggling the usual work and family commitments with study and exam preparation. It is important that all doctors and medical students take the time to look after themselves, and seek help and support when it is needed. GP Dr Hilton Koppe has developed a useful wellbeing checklist for doctors:

Physical wellbeing. How is your health? Do you have a regular GP, and when did you last have a check-up, or seek advice for a health problem? Are you prescribing your own medications? Do you eat well and take regular exercise? Mental wellbeing. This doesn’t just mean depression and anxiety, but habitual thought patterns, which may include negative patterns such as “I never have enough time”, or “I’m no good at …” Identifying these thoughts may help you to make changes in your life to improve your wellbeing. Spiritual wellbeing. This will mean different things to different people, but having a “world view”, or thoughts about meaning in life can help prevent burnout. Relationships. Which ones are important to you, and how are they going? Remember, relationships take time, effort and care. Do you have a close friend or mentor with whom you can discuss events at work and in your life, to “debrief ” with? Activities. Do you have at least one nonwork activity each week that you look forward to? How is your work-life balance going? Environment. What are your work and home environments like? Are these environments contributing to your levels of stress and discontent? Or do they help with your feelings of wellbeing and contentedness?

DO IT NOW If you have concerns about your health, or feel you aren’t coping with things, who can you turn to? Your own GP. It is really helpful to have your own general practitioner to talk things over with. Doctors Health Advisory Service. www.doctorshealth.org.au Helpline (02) 9437 6552 (24 hours) or see website for numbers in other States. www.rcubed.org.au. A website developed by GPRA to give GP Registrars, prevocational doctors and medical students real strategies to build resilience. Useful books. Clode, D. 2004, The Conspiracy of Silence: Emotional Health among Medical Practitioners, Royal Australian College of General Practitioners, South Melbourne. Koppe, H. 2002, “Self Care Strategies for Doctors – Making Changes” in Australian Family Physician (AFP), 33: 569-572.

Use this checklist to identify areas in your life that might need some “maintenance”. Get into good habits early on in your training so that you can have a long, fruitful and enjoyable career. 

103

Keeping your balance

Real Resilience Resources

“There is an expectation that doctors should be superhuman and cope with anything. The reality is, we are human, and have rates of mental health disorders and suicide at least equal to that of the general community. Our aim with this website is to promote self-care in a dynamic and fresh way that brings its significance into the consciousness of our members.” Dr Belinda Guest, GPRA Chair

104

About General Practice training The General Practice vocational training landscape is organised a little differently from other specialities. To the novice it can seem confusing at first, but you

What is RCUBED? RCUBED is a GPRA initiative that combines the best resilience resources in one website. Resilience means the ability to bounce back after inevitable demands. The easy-to-use resources can also be used for patients: Meditations – for example, mini meditations to listen to. Self-talk strategies. Tips to manage your own health. Time management. Goal setting. Physical fitness ideas. Inspiration. Fun stuff.

will soon find it easy to navigate.

If you are a GPRA member, look for the regular RCUBED e-newsletter in your inbox.

www.rcubed.org.au

About General Practice Training

Structure of the Australian General Practice Training program FACRRM QUALIFICATION (ACRRM)

Year One

Year Two

Core Clinical Training Time 12 months

Primary Rural & Remote Training 2 x 6 months

The

GP training

landscape

FRACGP QUALIFICATION (RACGP)

Possible equivalence* <=>

Joint training opportunities are available†

Hospital Training Time 12 months

GP Terms GPT1 – 6 months GPT2 – 6 months

These frequently asked questions will give you a better insight into how GP training is structured.

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

What is the difference?

Year Three

Primary Rural & Remote Training 2 x 6 months

Joint training opportunities are available†

GPT3 6 months

Extended Skills 6 months FRACGP (VR)

Year Four

Note: Fourth year is for FACRRM & FARGP candidates

Advanced Specialised Training 12 months

Possible equivalence* <=>

FACRRM (VR)

* Credit given for AGPT training already undertaken towards one Fellowship, prior to undertaking a second or third Fellowship † Can be achieved in dual accredited practices or posts

106

Advanced Skills Training (12 months) for FARGP

Nearly all other training programs in Australia are essentially run by the colleges such as the College of Physicians, Surgeons or Emergency Medicine. The colleges select applicants, provide training material, play a part in organising educational activities (although these are primarily delivered by the relevant hospital) and set training standards and the examination. Registrars work in the hospital system under the supervision of Consultants. GP training most obviously differs from other training programs in that, other than the initial year of Hospital Terms, it occurs mostly in a private practice setting. What may not be as obvious is that the two colleges of General Practice, the Royal Australian College of General Practitioners (RACGP) and the Australian College of Rural and Remote

Medicine (ACRRM), are not responsible for all aspects of GP training.

Who is GPET (General Practice Education and Training Ltd)? GPET is a wholly owned government company established in 2001 by the Commonwealth Government to fund and oversee General Practice vocational training in Australia. Australian General Practice Training (AGPT) is the name of the training program for GP Registrars. GPET contracts with Regional Training Providers (RTPs) Australia-wide, which deliver the AGPT program to about 2,500 GP Registrars. Selection of candidates is initially organised by GPET in conjunction with RTPs, who interview applicants.

What are RTPs? RTP stands for Regional Training Provider. RTPs contract with GPET and deliver the AGPT program in their designated region. Candidates applying for GP training are asked to nominate and rank in order of preference the RTPs in which they are willing to train. The administration 

107

About General Practice Training

of the training program, delivery of educational activities and training material are provided by the RTPs. For those training in isolated rural locations, there is another alternative to the RTPs – the Remote Vocational Training Scheme (RVTS).

What are the training pathways and obligations? You can enrol to do the General Pathway or Rural Pathway. Doctors from overseas who are affected by the 10 Year Moratorium are required to do the Rural Pathway (see page 130). If you do the General Pathway, you are required to do 12 months of your training in a rural or outer metropolitan location, or six months in each as approved by your RTP to meet workforce needs.

What is the role of the two colleges of General Practice? RACGP and ACRRM set training standards, set examinations and assessments, accredit training placements and sign off on completion of training by Registrars. Attainment of the Fellowship of the RACGP (FRACGP) or the Fellowship of ACRRM (FACRRM) is necessary to become vocationally registered for independent General Practice in Australia under the Medicare system. 108

About General Practice Training

ACRRM has specifically designed its curriculum to meet the needs of doctors practising in the rural and remote context. However, Fellows of ACRRM may ultimately practise anywhere in Australia – rural and remote or urban.

In such an environment, with so many different entities involved, and each with a slightly different focus on GP training, it also highlights the importance and relevance of General Practice Registrars Australia (GPRA).

The RACGP’s curriculum is designed to prepare GPs for practice in any setting.

GPRA works hard on behalf of Registrars to identify and rectify any problems and inconsistencies that may occur when there are so many different stakeholders involved in GP training.

Those who want to complement their FRACGP with more specialised rural and remote skills can do the RACGP’s Fellowship in Advanced Rural General Practice (FARGP). However, it is important to note that the FARGP is a complementary qualification not a standalone Fellowship for vocational registration. It is designed as a fourth year of advanced rural and remote skills for those who have completed their FRACGP.

Contributed by Dr George Manoliadis and Dr Jenny Lonergan

FACT FILE For more information about the GP training landscape, visit:

www.agpt.com.au www.racgp.org.au www.acrrm.org.au www.gpaustralia.org.au www.gpsn.org.au www.gpra.org.au

Other optional additional training for rural and remote practice is available. Registrars may be eligible for additional Emergency Skills courses. You may wish to complete one, two or three qualifications (FRACGP/FARGP and FACRRM) and this can be integrated into your training course from the beginning.

Why does all this matter? Understanding the structure and the fact that a number of entities are involved in GP training may help to explain some of the paperwork and hopefully reduce confusion. 109

General Practice Training Landscape

The

RACGPFellowship How to become a general practitioner by attaining Fellowship of the Royal Australian College of General Practitioners (FRACGP). What is the FRACGP? The Royal Australian College of General Practitioners Fellowship (FRACGP) is a three-year program, comprising one year of hospital residency, 18 months of General Practice placements and six months of Extended Skills. FRACGP is granted to those who have undertaken suitable experience and/or training in General Practice and demonstrated their competence by successfully completing the college examination to achieve vocational registration. FRACGP meets the required standard for doctors wishing to practise as an unsupervised general practitioner anywhere in Australia.

110

FRACGP is also recognised by many overseas colleges including the General Practice/ Family Physician Colleges in New Zealand, Ireland, Hong Kong and Malaysia. (Note that some of these countries require additional assessment prior to working there.)

Further training options The Advanced Academic Term is an optional fourth year, allowing part-time work within a university department and part-time work in clinical General Practice. Optional Advanced Rural Skills Posts (ARSPs) can be undertaken at any time during training and offer additional procedural skills in rural General Practice. Examples include Anaesthetics, Aboriginal Health, Obstetrics, Emergency Medicine and Mental Health.

The college also offers an additional Fellowship qualification – Fellowship in Advanced Rural General Practice (FARGP). (For further information, see page 114.)

About the FRACGP examination The FRACGP examination comprises: »» two written segments – the Applied Knowledge Test (AKT) and Key Feature Problems (KFP); »» plus one clinical segment – the Objective Structured Clinical Examination (OSCE). You must successfully complete the three assessments within a three-year period. You may sit each segment of the exam individually at your own pace. However, you must sit and pass the Applied Knowledge Test (AKT) before you can continue to other assessments.

Am I eligible to sit the examination?

When can I apply to sit the FRACGP exam?

To be eligible to sit the college examination, all Registrar candidates are required to: Have current medical registration.

You can apply to sit the college examination while completing your General Practice training and when you meet the eligibility criteria. Your Supervisor or Medical Educator can advise you if they think you are ready, or if you may be best to wait another six months before you sit the exam.

Be a current financial member of the RACGP. Have achieved certified competence in a recognised CPR course in the 12 months prior to enrolment. Be a General Practice Registrar undertaking Australian General Practice Training.

FACT FILE For more information, visit www.racgp.org.au

Contributed by the Royal Australian College of General Practitioners

Have completed eight active units of training in Australian General Practice Training which may include approved Recognition of Prior Learning (RPL), or at least 12 months in the Remote Vocational Training Scheme (RVTS).

111

Stimulate your mind with general practice

Medical school 4â&#x20AC;&#x201C;6 years Internship year (PGY1) You can apply for general practice training in this year to commence your first year of training in your second year after graduation. Postgraduate resident years You must complete at least 1 year of hospital experience, however, many people benefit from 2 or more years experience. You can undertake as many postgraduate years as you wish before applying for general practice training.

Application for general practice training General Practice Education and Training 9GPET) is the body that selects you for the Australian General Practice Training (AGPT) program. The training is delivered by one of the Regional Training Providers throughout Australia.

General practice training (general practice registrar) 3 years comprising 1 year of hospital residency including a rotation caring for sick children; 18 months of general practice placements; and 6 months extended skills in a term of your choice. Part time training and up to 3 years leave are available. RACGP college examination

Prevocational General Practice Placements Program (PGPPP)* (optional) Work in outer metropolitan, regional, rural or remote areas and gain practical experience in general practice. *please check entrance eligibility with your state/territory as it may vary

4th year training (optional) The advanced academic terms allow you to work part time within a university department and part time in general practice. The advanced rural skills posts are designed for doctors to gain additional skills relevant to rural general practice. These may be undertaken at any time throughout your training depending on your educational needs.

Successful completion of RACGP training and assessment RACGP Fellowship You are now qualified to practise unsupervised as a GP. QA&CPD General practitioners undertake quality assurance and continuing professional development throughout their medical career to maintain their professional standing.

Additional eduation in rural general practice The college offers further rural education through our Fellowship in Advanced Rural General Practice (FARGP). You can work toward this qualification at the same time as you prepare for your FRACGP.

A career in general practice offers many benefits such as variety, high patient contact and flexible working hours. The breadth and depth of intellectual knowledge required by general practitioners makes general practice not only a rewarding career but also an intellectually stimulating one. Whether you are working towards a career in general practice or still considering your options, as a medical student you are invited to take up RACGP student membership.

Join the RACGP today Download and complete an application form at www.racgp.org.au/student or call 1800 331 626

About General Practice Training

The RACGP’s Fellowship in Advanced Rural General Practice

(FARGP)

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

FACT FILE Registrars can get more information about the Fellowship in Advanced Rural General Practice (FARGP) from their RTP or by emailing di.schaefer@racgp.org.au at RACGP’s National Rural Faculty, phoning 1800 636 764 or visiting www.racgp.org.au/rural

114

What is the FARGP?

Requirements for FARGP

Registrars have a choice of two endpoints through the RACGP – the FRACGP to achieve General Practice vocational recognition (three years) and those who want recognition of their advanced rural and remote skills may continue to train to the FARGP (four years), and attain both the FRACGP and the FARGP.

Candidates must have completed their FRACGP before they can be awarded their FARGP.

The FARGP may also be used for hospital credentialing and appointments.

Assessment for FARGP is based on a Learning and Educational Assessment Portfolio (LEAP). There is no formal final examination as the portfolio is based on continuous assessment.

However, training to the RACGP curriculum and Advanced Rural Skills Training curriculum is closely integrated, so many requirements can be achieved concurrently.

Registrars must undertake a minimum of 12 months of training in accredited Rural Training Posts, plus 12 months in an accredited Advanced Rural Skills Training Post (ARSP).

Skills curricula have been developed in consultation with the other medical specialty colleges such as the RANZCOG (for Obstetrics), ANZCA (for Anaesthetics) and RACS (for Surgery). The FARGP also includes two core distance education modules – Working in Rural General Practice and Emergency Medicine. Registrars can design a program that responds to their specific interests. If circumstances change, Registrars have the flexibility to revert to the three-year FRACGP program only.

Contributed by Di Schaefer, RACGP National Rural Faculty

Advanced Rural Skills Posts (ARSPs) ARSPs are available in: Anaesthetics Obstetrics Surgery Aboriginal Health Mental Health Paediatrics Emergency Medicine Adult Internal Medicine Small Town General Practice Advanced Rural Skills Training can also be designed to meet the needs of an individual Registrar or their community; for example, Palliative Care, Drug and Alcohol Misuse, Musculoskeletal and Expedition Medicine. Individual ARSPs must be approved by the RACGP’s National Rural Faculty after consultation with your Medical Educator.

115

About General Practice Training

The

ACRRM

Fellowship

The Australian College of Rural and Remote Medicine (ACRRM) has specifically designed their GP training program to meet the needs of the rural and remote practitioner. What is the FACRRM? Fellowship of ACRRM is an approved pathway to vocational registration and unrestricted General Practice anywhere in Australia. It is a four-year integrated training program for Registrars wanting to train for Rural and Remote Medicine. The training occurs in an “on the job” environment as a Registrar in an accredited General Practice, Aboriginal Community Controlled Health Service, Royal Flying Doctor Service or as a medical officer in an accredited hospital setting. Candidates wishing to achieve a Fellowship of ACRRM are able to choose from three training pathways: the Vocational Preparation Pathway delivered by Regional Training Providers with funding from 116

GPET; the Remote Vocational Training Scheme (RVTS ) for doctors working in isolated rural communities who find it difficult to leave their community to participate in training; and the Independent Pathway which is suitable for doctors with experience in rural and remote who prefer self-directed learning. To see which pathway is most suitable for you see the ACRRM website for more information.

Vocational training program components The ACRRM training program comprises three spheres of learning and experience (see flowchart on page 118). Core Clinical Training. Candidates complete 12 months of training in an ACRRM-accredited metropolitan, provincial or regional/rural hospital. This should ideally include rotations

in General Medicine, Obstetrics and Gynaecology, Anaesthetics, General Surgery, Paediatrics and Emergency Medicine. Primary Rural and Remote Training. Candidates undertake 24 months of training in a combination of rural or remote ACRRM-accredited hospitals, Aboriginal Community Controlled Health Services or General Practices/communitybased facilities, or a combination of these. The Registrar works with increasing autonomy and manages an increasing range of conditions. The specific procedures, breadth and depth of practice are defined by the Primary Curriculum and Procedural Skills Logbook. Advanced Specialised Training. Candidates undertake 12 months of training in one of 10 ACRRM-accredited disciplines listed in the flowchart

on page 118. Many FACRRM candidates undertake training in a procedural discipline.

FACRRM assessment Candidates must work in accredited training posts and successfully complete the following assessments: Multisource Feedback (MSF), Mini Clinical Evaluation Exercise (miniCEX), Multiple Choice Question (MCQ) exam and Structured Assessment Using Multiple Patient Scenarios (StAMPS). There is considerable flexibility in the timing of the assessments and candidates are able to undertake each assessment component within or close to their local community. To achieve FACRRM, candidates must also successfully complete four ACRRM online modules and Emergency Skills courses approved by ACRRM (for example, EMST/ELS/PHTLS or equivalent, APLS, ALSO).

FACT FILE For more information, visit the ACRRM website (www.acrrm.org.au), call ACRRM on 1800 223 226 or contact ACRRM Vocational Training, training@acrrm.org.au

frequently asked questions How is FACRRM integrated into the AGPT program? Candidates enrolled in the AGPT can elect to train to either or both the FACRRM and the FRACGP. FACRRM training is open to both Rural and General Pathway Registrars. However, General Pathway candidates who wish to pursue FACRRM will need to undertake training within ACRRMaccredited training posts.

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

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

Contributed by the Australian College of Rural and Remote Medicine  117

About General Practice Training

The ACRRM Training Program

ACRRM REGISTRAR Core Clinical Training

12 Months In an ACRRM-accredited hospital Terms: • General Medicine • Obstetrics and Gynaecology • Anaesthetics • General Surgery • Paediatrics • Emergency Medicine

118

Primary Rural and Remote Training

Advanced Specialised Training

24 Months

12 Months

In any of the following:

One of the following:

• Rural Hospital • Aboriginal Community Controlled Health Service • Rural Generalist Practice • RFDS

• Anaesthetics • Obstetrics and Gynaecology • Surgery • Population Health • Remote Medicine • Emergency Medicine • Indigenous Health • Adult Internal Medicine • Mental Health • Paediatrics

NB: Primary Rural and Remote Training and Advanced Specialised Training may be undertaken in any order after the Core Clinical Training year

The

About General Practice Training

a force in GP training

Around 2.5% of GPs train in the Australian DeFence force. It’s an opportunity to develop leadership skills and specific medical skills IN A CHALLENGING ENVIRONMENT.

raining as a GP Registrar in the Australian Defence Force (ADF) offers opportunities and challenges. ADF Registrars must meet the same educational requirements but there are some specific policies relating to ADF GP Registrars to allow for the exigencies of service. These include leave provisions, transfer between RTPs and modified requirements regarding work in outer metropolitan and rural areas.

Civilian and military posts General Practice Terms are undertaken through a combination of civilian and military posts, known as composite terms. Generally, composite terms are accredited only after an initial full-time civilian term, usually a three-month Rural Term (see the AGPT website for policies).

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While most ADF Registrars will select the General stream, exposure to Rural General Practice provides valuable experience in the decisionmaking, leadership, teamwork and clinical skills that can be utilised for ADF clinical practice in Australia and when deployed. Deployments may be prospectively accredited for training. This requires consideration of the proposed learning plan, supervision arrangements and access to support, and requires liaison with the RTP Medical Educator and the State Censor. Initially, Medical Officers (MOs) in the ADF are encouraged to specialise in primary care. This is important because whether in Australia or deployed, ADF personnel need access to high quality primary health care. There are also opportunities to specialise in Public Health,

Medical Administration, Occupational Medicine and Sports Medicine, known in Defence as the force protection specialties. Generally, the procedural specialties (Surgery, Anaesthetics, Orthopaedics) required for providing higher level care on deployments reside within the Reserve Forces.

ADF Medical Officer recruitment Most ADF MOs are recruited as medical students, some directly from universities and others from within the Services. Those recruited from within the Navy, Army or Air Force will have had a prior career in the ADF before selection for re-specialisation to MO. A small number join as direct entry qualified medical practitioners. Medical students and trainees are considered ADF members and attract a salary and

other ADF benefits such as superannuation, allowances, medical and dental care, and accommodation options while under training. The MO’s primary duty is to train at medical school, then complete PGY1 and 2 prior to their first full-time posting to an ADF unit. At the unit, the MO receives further training, in parallel with the AGPT, including officer training, Early Management of Severe Trauma (EMST), and specialist courses such as Aviation Medicine or Underwater Medicine. At the same time, the MO gets acquainted with the military medical system and the environment in which they work.

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

Remuneration In return for supporting the initial medical training, the

“You have the opportunity to manage young men who would normally present reluctantly in the wider community. The exposure to areas such as Sports Medicine, Travel Medicine and Occupational Medicine is significant.”

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

Scope of work ADF MOs are the primary care physicians for ADF personnel. This unique demographic necessitates concurrent exposure to the broader Australian community through civilian and composite terms. Although the exposure to Paediatrics and Geriatrics is limited within the Defence environment there are opportunities. For example, you have the opportunity to manage young men who would normally present reluctantly in the wider community.  121

About General Practice Training

MEDICAL OBSERVER for

Unique challenges

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

The exposure to areas such as Sports Medicine, Travel Medicine and Occupational Medicine is significant.

Humanitarian efforts Additionally, ADF MOs need skills to operate at the front line wherever the ADF deploys forces or undertakes humanitarian operations such as help for the injured from the Bali bombing or tsunami disaster relief in Banda Aceh. The Defence website lists current military operations in Australia and overseas, most of which involve an MO presence. After completing their initial obligation, MOs may choose to transfer to the Reserve Forces, however some continue full-time and provide ongoing leadership in Australiaâ&#x20AC;&#x2122;s military medical services.

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The RACGP also has a Chapter of Military Medicine for GPs employed in the Australian Defence Force. MOs in the ADF find opportunities to participate in diverse experiences in primary care, reflecting the diversity of General Practice overall. They operate as part of, and often lead, a multidisciplinary team in achieving visible outcomes in a field that is frequently highlighted as worthwhile and promoting Australian interests. Service as a Defence MO provides a supportive, collegiate environment, but it is not for the faint-hearted. The spectre of military discipline is actually not too far removed from other ideas of self-discipline and responsibility. Other exciting challenges include learning about the military medical system, military specialised areas such as Aviation, Underwater and Sports Medicine and the opportunity to move interstate and deploy overseas supported by the organisation.

Contributed by Dr Geoff Menzies

REGISTRARS

BRINGS LIFE TO MEDICINE

Register with Medical Observer for s 0!4)%.4 (!.$/543 s '5)$% 4/ '5)$%,).%3 s %!2. #0$ 0/).43 s #/.&%2%.#% #!,!.$%2 s 2%3/52#% ,)"2!29 s ,%'!, !.$ &).!.#)!, !$6)#%

Find MOâ&#x20AC;&#x2122;s coverage for registrars at medicalobserver.com.au/registrar or search the registrar section at medicalobserver.com.au/advancedsearch

About General Practice Training

Jargon

buster

Acronyms and abbreviations abound in the language of GP training. Crack the code here! AAAPC – The Australian Association for Academic Primary Care Formerly AAAGP. AAPM – Australian Association of Practice Managers ACIR – Australian Childhood Immunisation Register ACRRM – Australian College of Rural and Remote Medicine One of two General Practice colleges. Has a curriculum of educational objectives for rural GPs and a Fellowship process for vocational recognition. AFP – Australian Family Physician The official journal of the RACGP. AGPAL – Australian General Practice Accreditation Ltd This organisation completes accreditation of practices throughout Australia. AGPN – Australian General Practice Network The national body that represents the Divisions. Previously Australian Divisions of General Practice. 124

AGPT – Australian General Practice Training The training program for GP Registrars. AIDA – Australian Indigenous Doctors Association AKT – Applied Knowledge Test A component of the RACGP Fellowship exam. AMPCo – Australian Medical Publishing Company Register with them to get a free subscription to Medicine Today, Australian Doctor and Medical Observer. To arrange this, visit www.ampco.com.au AMA – Australian Medical Association An independent organisation that represents the professional interests of all doctors including political, legal and industrial.

Divisions of General Practice Federally funded to provide support and educational activities to GPs and local primary care services within their Division (local area); for example, diabetes nurse educators. Find out which Division your practice belongs to and join. (GP Registrar membership is free in some regions.)

FRACGP – Fellow of the Royal Australian College of General Practitioners

DHAS – Doctors Health Advisory Service

GPR – General Practice Registrar; GP Registrar

DoHA – Department of Health and Ageing The Commonwealth Government Department responsible for health and ageing.

GPRA – General Practice Registrars Australia Ltd Represents GP Registrar issues to AGPT, RACGP, ACRRM, DoHA and many other bodies involved in training. Membership is currently free.

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

AMH – Australian Medicines Handbook

ECT – External Clinical Teacher

AMSA – Australian Medical Students' Association

FACRRM – Fellow of the Australian College of Rural and Remote Medicine

ARSP – Advanced Rural Skills Post CMO – Career Medical Officer

FARGP – Fellowship in Advanced Rural General Practice

GPET – General Practice Education and Training Limited Government limited company which funds and contracts with RTPs.

GPRIP – General Practice Rural Incentives Program GPSA – General Practice Student Ambassador/ General Practice Supervisors Association GPSN – General Practice Students Network HIC – Health Insurance Commission Now known as Medicare Australia. HMO – Hospital Medical Officer  125

About General Practice Training

HWA – Health Workforce Australia

NRHSN – National Rural Health Students Network

IMG – International medical graduate Also known as OTDs (overseas trained doctors). GP Registrars who are IMGs/OTDs may be subject to the 10 Year Moratorium.

OSCE – Objective Structured Clinical Examination A component of the RACGP Fellowship exam.

JAC – Joint Advisory Committee JCC – Joint Consultative Committee KFP – Key Feature Problems A component of the RACGP Fellowship exam. MBS – Medicare Benefits Schedule ME and TA – Medical Educators and Training Advisors MCQs – Multiple choice questions (a component of the RACGP Fellowship exam) NGPSA – National GP Supervisors Association Not to be confused with the SLON (Supervisor Liaison Officer Network), although they are essentially same people. NGPSA is the GPRA equivalent for Supervisors. They undertake an advocacy role for Supervisors, particularly in terms and conditions negotiations. NPS – National Prescribing Service A Commonwealth Government-funded organisation that provides independent information on the prescription and use of various medications. Lots of resources and case studies for GP Registrars can be found at www.nps.org.au

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OTC – Over the counter OTD – Overseas trained doctor – see IMG Also known as IMGs (international medical graduates). May be subject to the 10 Year Moratorium. PBS – Pharmaceutical Benefits Scheme/ Pharmaceutical Benefits Schedule PIP – Practice Incentives Program PGPPP – Prevocational General Practice Placements Program QA and CPD – Quality Assurance and Continuing Professional Development RACGP – Royal Australian College of General Practitioners One of two General Practice colleges. Has a Fellowship process for vocational recognition. RACGP also offers a Fellowship in Advanced Rural General Practice (FARGP). RACGP Library RACGP members can access the full suite of services provided by the RACGP John Murtagh Library. Non-members can access some services for a fee. Visit www.racgp.org.au/library

RACGP State Censor A Fellow of the RACGP in each State. Checks that the GP Registrar has completed training requirements for the awarding of Fellowship of the RACGP.

RTP – Regional Training Provider RTPs tender for contracts from GPET to provide regionalised GP training.

RDAA – Rural Doctors Association Australia Has State branches. Represents rural doctor issues to government and other organisations.

SBO – State-Based (Divisional) Organisation A State-funded organisation, not always directly linked to ADGP or individual Divisions. Provides some educational activities that GP Registrars can attend.

RDL – Registrar-directed learning

SIP – Service Incentive Payment

RFDS – Royal Flying Doctor Service

SLO – GP Supervisor Liaison Officer Employed by an RTP to represent and advocate for GP Supervisors.

RHWA – Rural Health Workforce Australia RRIPS – Registrars Rural Incentive Payments Scheme To be replaced by the General Practice Rural Incentives Program (GPRIP) from 1 July 2010. RLO – Registrar Liaison Officer Employed by an RTP to represent and advocate for GP Registrars. RMO – Resident Medical Officer RPBS – Repatriation Pharmaceutical Benefits Scheme/Repatriation Pharmaceutical Benefits Schedule RROC – Registrar Representative on Council RRADO – Registrar Research and Development Officer

TA – Training Advisor TGA – Therapeutic Goods Administration TMO – Trainee Medical Officer UGPA – United General Practice Australia VMO – Visiting Medical Officer VR – Vocational registration; vocational recognition WONCA – World Organisation of National Colleges, Academies and Academic Associations of General Practitioners/Family Physicians

Contributed by Dr Siew-Lee Thoo, Dr Naomi Harris and Dr Kate Kelso

RSRF – Registrar Scholarship and Research Fund

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GENERAL PRACTICE

EXPLORE THE POSSIBILITIES

Explore the possibilities offered by a career in General Practice. • Diverse workload • Management of complex issues • Independence whilst still being involved in a team

• Continuity of care • Participation in community • Extensive Clinical Exposure

The Australian General Practice Training (AGPT) program is delivered in Victoria by five Regional Training Providers, committed to providing high quality programs, a strong level of support and training of doctors in challenging medicine. Experienced medical educators and GP supervisors mentor and support doctors in the program. The three-year flexible training program offers an excellent grounding for a career in General Practice in both urban and rural settings. To find out more about the training program in Victoria, contact any of the training providers.

Bogong Regional Training Network www.bogong.org.au

Gippsland Education & Training for General Practice Ltd (get GP) www.getgp.net.au

Greater Green Triangle GP Education & Training www.ggtgpet.com.au

VMA General Practice Training www.vma.com.au

Victoria Felix Medical Education www.vicfelix.com.au

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

About General Practice Training

The 10 Year Moratorium and rural training Are you a medical student from overseas who was a temporary resident when you began your Australian degree? Then you may be required to do your GP training in the Rural Pathway. Australia has a shortage of general practitioners, especially in rural and remote areas as well as outer metropolitan areas. Doctors from overseas are being welcomed to help fill Australiaâ&#x20AC;&#x2122;s GP gap. However, to ensure Australiaâ&#x20AC;&#x2122;s migrant doctors practise in the geographic regions of greatest need, the Commonwealth Government has a policy of only issuing these doctors with a Medicare provider number if they work in certain rural and outer metropolitan areas.

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This means that GP Registrars who have migrated to Australia usually do their vocational training in the Rural Pathway. Generally, the geographic limitation on provider numbers lasts for 10 years, which is why the scheme is known as the 10 Year Moratorium. The 10 Year Moratorium applies to international medical graduates (IMGs) (with the exception of New Zealand graduates) and Australian medical graduates who were Australian temporary residents when they commenced their primary medical degree.

IMGs are also sometimes known as OTDs (overseas trained doctors). The 10 Year Moratorium is currently under review and anticipated changes may see the rules become more favourable for migrant doctors.

FACT FILE What is the 10 Year Moratorium?

Under section 19AB of the Health Insurance Act, medical practitioners subject to the moratorium are not able to attract Medicare benefits for a period of 10 years from the time they become registered as a medical practitioner in Australia with a State or Territory Medical Board or from when they first become permanent residents of Australia (unless they meet exemption criteria). In effect, this means they can practise but only in areas designated by the government in rural, remote and outer metropolitan areas.

Who is under the 10 Year Moratorium?

Overseas trained doctors who did not obtain their primary qualification in Australia (excluding New Zealand-trained doctors). Overseas doctors trained in Australia (that is, any doctor who began studying in Australia under a temporary visa and subsequently obtained their primary qualification from an Australian university). For more information, visit www.agpt.com.au

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About General Practice Training

Applying for GP training When can I apply? The earliest time you can apply for Australian General Practice Training (AGPT) is in your Intern year, which means you will enter the program as a second year postgraduate.

Am I eligible? You must have Australian or New Zealand citizenship or permanent residency, medical qualifications and medical registration. Doctors affected by the 10 Year Moratorium can only apply for the Rural Pathway. (See the article on page 130.)

What does training involve? Unlike the other specialties, you donâ&#x20AC;&#x2122;t choose a hospital each year. General Practice training is unique in that your training is primarily delivered through a regionally based model, with one of the Regional Training Providers (RTPs) across Australia.

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All RTPs deliver the same components of training, which consists of both on-the-job training and formal training. However, they may do this in slightly different ways and offer you slightly different opportunities. Excellent information about each RTP can be found at www.agpt.com.au

What are the General Practice colleges? There are two General Practice colleges that formulate curriculum, exams and assessments for a Fellowship in General Practice â&#x20AC;&#x201C; the Royal Australasian College of General Practice (RACGP) and the Australian College of Rural and Remote Medicine (ACRRM).

FACT FILE For more information, visit www.agpt.com.au

About General Practice Training

Regional Training Providers in Australia T

here are numerous Regional Training Providers (RTPs) across Australia, so countless training adventures await you. The sweeping diversity of Australia’s geography and people gives rise to a localised vocational training model that responds to clinical challenges

specific to each region. It also opens the way for GP Registrars to tailor their training to suit their particular interests and passions – and see Australia along the way. Visit all RTPs through one convenient source at www.agpt.com.au

Northern Territory GP Education

WAGPET Adelaide to Outback GP Training

Tropical Medical Training

Queensland Rural Medical Education PLUS Central & Southern Qld Training Consortium

North Coast GP Training

Beyond Medical Education (BME) BME Sturt Fleurieu GP Education & Training

NOTE: Some areas of Australia are designated “shared zones”. These areas are currently shared by more than one RTP. For further information on training in these areas, please contact the relevant RTPs directly via their websites.

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BME

getGP/Greater Green Triangle GP Education & Training Victorian Metropolitan Alliance PLUS getGP/Greater Green Triangle GP Education & Training GP Training Tasmania

Central & Southern Qld Training Consortium

GP Training Valley to Coast GP Synergy WentWest CoastCityCountry Training Bogong getGP/Greater Green Triangle GP Education & Training Victorian Metropolitan Alliance

9 Info FILE

INFO FILE

GPSN

CALENDAR 2010

National and International Key Dates Name

Location

Dates

Breathing NEWLIFE into General Practice Conference

Canberra

15-18 March 2010

WONCA 2010 Regional Conference

Cancun, Mexico

19-23 May 2010

GPSN Schwartz First Wave Scholarship applications

Visit www.gpsn.org.au for further information

Mid-June

Global Health Convention

Tasmania

1-4 July 2010

AMSA Convention

Tasmania

5-11 July 2010

National University Rural Health Conference

Alice Springs

15-17 July 2010

GPET Convention

Alice Springs

8-9 September 2010

GPSN Schwartz First Wave Scholarship Orientation Workshop

Melbourne

18-19 September 2010

GPSN National Council Meeting

Sydney

2-3 October 2010

RACGP Conference

Cairns

6-9 October 2010

Rural Medicine Australia (ACRRM and RDAA)

Hobart

22-24 October 2010

AGPN National Forum

Perth

3-6 November 2010

GPSN Local Events Event GPSN Icebreaker Events GPSN Clinical Workshops/GP Experience Events GPSN Career Expos GPSN End of Year Events/Elections Check with the GPSN club at your university for details.

We want your feedback on Aspire 2010 We aim to continually improve the support we offer medical students and we value your opinions and constructive comments.

• Were the articles and information valuable to you? • Are there any other topics you would like to see? • Is there anything you would like to see more of? • Is there anything you would like to see less of? • Do you have any suggestions for future topics? • Are you interested in writing an article for future editions? • Are you interested in assisting the editorial team?

Please send us your feedback by email at gpsn.publications@gpra.org.au or by phone on 1300 131 198

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T: 1300 131 198 www.gpsn.org.au E: gpsn.enquiries@gpra.org.au