microsoft word - web viewcurrent version\mccc registrar handbook v4.0. 21.04.2017. docx" page...

$: Microsoft Word - Web viewCurrent Version\MCCC Registrar Handbook V4.0. 21.04.2017. docx" Page 56 of 68. Registrar Handbook. 2017. 1General information5. 1.1Glossary of Terms5$
Registrar Handbook2017

1 General information....................................................................................................51.1 Glossary of Terms............................................................................................................51.2 The role of Murray City Country Coast GP Training (MCCC)..............................................7

1.2.1 MCCC Vision...................................................................................................................81.2.2 MCCC Mission................................................................................................................81.2.3 MCCC Values..................................................................................................................8

1.3 CEO welcome..................................................................................................................91.4 MCCC contact details.....................................................................................................101.5 Important resources......................................................................................................11

1.5.1 Pivotal: MCCC’s Online Administration Platform.........................................................111.5.1.1 Support for Pivotal................................................................................................................111.5.1.2 Accessing MeL.......................................................................................................................121.5.1.3 Support for MeL....................................................................................................................121.5.1.4 MCCC Website......................................................................................................................12

2 MCCC’S educational approach...................................................................................132.1 The medical education team..........................................................................................13

2.1.1 Director of Medical Education & Training (DMET).......................................................132.1.2 Medical Educators (MEs).............................................................................................132.1.3 Supervisors...................................................................................................................142.1.4 Training Advisor Review Meeting................................................................................142.1.5 External Clinical Teaching Visitor.................................................................................142.1.6 Registrar Liaison Officers (RLOs)..................................................................................14

2.2 The education program.................................................................................................152.2.1 In-practice....................................................................................................................152.2.2 Out-of-practice.............................................................................................................16

2.2.2.1 Face-to-Face..........................................................................................................................162.2.2.2 Directed Learning..................................................................................................................162.2.2.3 Self-directed learning............................................................................................................172.2.2.4 Mental Health Skills Training.................................................................................................17

2.2.3 Your learning plan........................................................................................................172.2.4 Pastoral and Learning Support.....................................................................................18

2.3 Registrar and family support..........................................................................................182.3.1 Self-Care.......................................................................................................................19

2.3.1.1 Other Resources....................................................................................................................192.3.2 Safety Promotion and Risk Management.....................................................................19

2.3.2.1 Introduction..........................................................................................................................192.3.2.2 Registrar Disclosure of Risk Factors.......................................................................................202.3.2.3 Fatigue Management............................................................................................................202.3.2.4 Registrar Safety Training.......................................................................................................202.3.2.5 Safety in the Clinic.................................................................................................................212.3.2.6 Safety After-Hours.................................................................................................................212.3.2.7 Resources..............................................................................................................................212.3.2.8 Safety on the Road................................................................................................................212.3.2.9 Safety at ‘Out-of-Practice’ Educational Events......................................................................21

2.4 Confidentiality and privacy............................................................................................232.5 The AGPT program........................................................................................................25

2.5.1 Professional recognition as a general practitioner.......................................................252.5.2 The roles of the two Colleges (ACRRM and RACGP).....................................................25

2.6 Choosing a pathway......................................................................................................262.6.1 Training towards Fellowship of Royal Australian College of General Practitioners (FRACGP) 26

"Z:\Training Ops\Handbooks & Resources\3. Current Version\MCCC Registrar Handbook V4.0. 21.04.2017. docx"

Page 2 of 70

2.6.1.1 Summary of training units and terms offered in RACGP training..........................................262.6.1.2 Advanced training terms.......................................................................................................272.6.1.3 Extended Skills Training.........................................................................................................272.6.1.4 Training towards Fellowship in Advanced Rural GP (FARGP).................................................272.6.1.5 Academic Posts.....................................................................................................................28

2.6.2 Training for Fellowship of Australian College of Rural Remote Medicine (FACRRM)...29

3 The registrar’s journey...............................................................................................313.1 Hospital Terms..............................................................................................................31

3.1.1 Mandatory Paediatric Training....................................................................................313.1.2 Hospital Training (RACGP)/CCT (ACRRM) Requirements.............................................323.1.3 Hospital Registrar Education Program.........................................................................32

3.2 Practice ready................................................................................................................333.2.1 Being Matched to a Practice........................................................................................333.2.2 What to do prior to commencing a GP Term...............................................................33

3.2.2.1 Registrar to provide to Practice.............................................................................................343.2.2.2 Practice Manager to provide to registrars.............................................................................34

3.2.3 How to acquire provider numbers...............................................................................343.3 Recognition of prior learning.........................................................................................35

3.3.1 Recognition of prior learning without time credit........................................................363.3.1.1 Further information about RACGP RPL.....................................................................................363.3.1.2 Further information about ACRRM RPL....................................................................................36

3.4 Commencement of Training...........................................................................................363.5 Practice Orientation......................................................................................................363.6 GPT1, 2 & 3 (RACGP) or PRRT1, 2 & 3 (ACRRM) registrars...............................................373.7 Training Time Calculations.............................................................................................37

3.7.1 Full Time Training.........................................................................................................373.7.1.1 Full time training breakdown................................................................................................37

3.7.2 Part Time Training........................................................................................................383.7.2.1 Part time training breakdown...............................................................................................38

3.8 Supervision Requirements.............................................................................................393.9 Patient Numbers...........................................................................................................393.10 Registrar training and consultation information (RCTI)...................................................393.11 Diversity of Practice Experience (RACGP Ruling).............................................................393.12 Assessments..................................................................................................................40

3.12.1 Initial Assessment (GPT1/PRRT1)...................................................................................423.12.1.1 Situational Judgement Test (SJT), Candidate Assessment Applied Knowledge Test (CAAKT) Score.........................................................................................................................................423.12.1.2 Multiple Choice Questionnaire (MCQ)..................................................................................423.12.1.3 Clinical Scenarios...................................................................................................................423.12.1.4 External Clinical Teaching Visit (ECTV)...................................................................................433.12.1.5 Supervisor Report.................................................................................................................433.12.1.6 Practice Manager Report......................................................................................................43

3.12.2 Further Assessment (GPT2/PRRT2)..............................................................................443.12.2.1 MCQ......................................................................................................................................44Completed online on MEL in your own time in the week before and after commencing GPT2/PRRT2. There are 140 questions (SBA) pitched at FRACGP level. Questions are in batches on topic areas and are time limited. Batches can be completed individually.......................................................................443.12.2.2 A DISQ (Doctors Interpersonal Skills Questionnaire).............................................................44DISQ is administered by Client Focused Evaluations Program (CFEP). They send out 40 questionnaires to the registrar with instructions on how they must be administered in week 2 of the GPT2/PRRT2 term........................................................................................................................................................443.12.2.3 ECTV......................................................................................................................................44


Page 3 of 70

An early external clinical teaching visit will be arranged for an ME to visit and sit in on consultations. The ME will observe you consulting and provide feedback. This will occur between weeks 6-8............443.12.2.4 Supervisor report..................................................................................................................453.12.2.5 Practice manager report.......................................................................................................45

3.12.3 ECTV.............................................................................................................................453.12.3.1 Arranging your External Clinical Teaching Visit (ECTV)..........................................................45

3.12.4 Other Assessments......................................................................................................463.12.4.1 MiniCEX (for ACRRM registrars only)....................................................................................46

3.12.5 Exams...........................................................................................................................463.12.5.1 Examination Preparation.......................................................................................................46

3.13 Training time cap...........................................................................................................473.14 Extension of training time..............................................................................................473.15 Fellowship.....................................................................................................................473.16 Subsidies and grants......................................................................................................47

3.16.3 Registrar Subsidies.......................................................................................................483.16.3.1 Accountability of MCCC and of Registrars.............................................................................48

3.16.4 Rural Procedural Grants Program................................................................................483.17 Overseas Trained Doctors (OTDs)...................................................................................483.18 Complaint procedure.....................................................................................................48

4 Appendices................................................................................................................504.12 Appendix A: Policies and forms......................................................................................50

4.12.3 AGPT policies and forms..............................................................................................504.12.3.1 Program Policies....................................................................................................................504.12.3.2 Forms....................................................................................................................................50

4.12.4 RACGP policies and forms............................................................................................514.12.4.1 RACGP Examination policies..................................................................................................514.12.4.2 Fellowship pathway policies..................................................................................................514.12.4.3 Education Services exceptions policies..................................................................................514.12.4.4 Forms....................................................................................................................................51

4.12.5 ACRRM policies............................................................................................................524.12.6 MCCC policies, forms and documents..........................................................................52

4.12.6.1 Education policies.................................................................................................................524.12.6.2 Training policies....................................................................................................................534.12.6.3 ACRRM MiniCEX Supervisor Pack..........................................................................................534.12.6.4 Assessment...........................................................................................................................534.12.6.5 Training.................................................................................................................................534.12.6.6 External Clinical Training Visits..............................................................................................544.12.6.7 Training Advisor Visits...........................................................................................................544.12.6.8 Feedback...............................................................................................................................544.12.6.9 Orientation............................................................................................................................544.12.6.10 Registrar claims for reimbursement.................................................................................544.12.6.11 Reviewing the progress of GP Registrars..........................................................................544.12.6.12 Complaints........................................................................................................................54

4.12.7 National Terms and Condition for the Employment of Registrars...............................544.13 Appendix B: Orientation................................................................................................554.14 Appendix C: Registrar competency benchmarking.........................................................59

This is a live document and maybe updated from time to time.

Please always refer to the electronic version available on the MCCC website.


Page 4 of 70

1 General information1.1 Glossary of Terms

ACRRM Australian College of Rural and Remote Medicine

AGPT Australian General Practice Training

AKT Applied Knowledge Test

ALS Advanced Life Support

AMS Aboriginal Medical Service

ARST Advanced Rural Skills Training (RACGP)

AST Advanced Specialised Training (ACRRM)

CBD Case Based Discussions

CCT Core Clinical Training (ACRRM)

DMET Director of Education and Training

DoH Department of Health

DRANZCOG Diploma of the Royal Australian College of Obstetricians and Gynaecologists

ETC Education Training Coordinator

ECTV External Clinical Teaching Visit

ESP Extended Skills Post

EST Extended Skills Term

FACRRM Fellowship of Australian College of Rural and Remote Medicine

FARGP Fellowship in Advanced Rural General Practice

FRACGP Fellowship of the Royal Australian College of General Practitioners

GP General Practitioner

GPR GP Registrar

GPRA GP Registrar Association

GPS GP Supervisor

GPT 1, 2, 3, 4 General Practice Term 1 - 4

HLO Hospital Liaison Officer

IMG International Medical Graduate

JCCA Joint Consultative Committee on Anaesthesia


Page 5 of 70

KFP Key Features Problem

LME Lead Medical Educator (holds a Portfolio)

MBS Medicare Benefits Schedule

MCCC Murray City Country Coast GP Training

MCQ Multiple Choice Question

ME Medical Educator

MiniCEX Mini Clinical Evaluation Exercise

MSF Multi-Source Feedback

NGPSA National General Practice Supervisors Association

OSCE Objective Structured Clinical Examination

OTD Overseas Trained Doctor

PALS Pastoral and Learning Support

PM Practice Manager

PRRT1, 2, 3, 4 Primary, Rural and Remote Training terms 1-4

RA Remoteness Area

RACGP Royal Australian College of General Practitioners

RCA Random Case Analysis

REAPS Registrar Education and Practice Support Coordinator

RFDS Royal Flying Doctor Service

RHE Regional Head of Education

RLO Registrar Liaison Officer

RPL Recognition of Prior Learning

RTO Regional Training Organisation

SLO Supervisor Liaison Officer

SMET Senior Medical Educator Team

StAMPS Structured Assessment using Multiple Patient Scenarios

TA Training Advisor

TSO Training Support Officer


Page 6 of 70

1.2 The role of Murray City Country Coast GP Training (MCCC)MCCC has been accredited by RACGP and ACRRM to offer the AGPT Program.

With offices in Bendigo, Parkville, Warrnambool and Wodonga, and training posts located throughout its footprint, MCCC focuses its education program on the preparation of doctors for metropolitan, suburban, rural and remote general practice.

MCCC is governed by a Board of Directors and managed by a Chief Executive Officer. The Board is drawn from a broad-based membership, including:

Training practices within our training footprint.

Universities with clinical schools within our training footprint.

Victorian hospitals within our training footprint.

GP Registrars Australia.

Royal Australian College of General Practitioners.

Australian College of Rural and Remote Medicine.

GP Supervisors Australia.

The education program is developed and overseen by a Senior Medical Education Team, headed up by the Director of Medical Education and Training (DMET) and including Regional Heads of Education (RHE) from all four of MCCC’s regions.


Page 7 of 70

1.2.1 MCCC Vision

Enhancing community health and wellbeing through leadership in general practice education, training, research and workforce development.

1.2.2 MCCC Mission

MCCC will provide high quality education and training programs for GP registrars, junior doctors interested in careers as GPs and where relevant, other general practice professionals.

MCCC will partner with:

General practices to support integration of education, training, research and clinical governance as core elements of quality general practice.

Universities, Primary Health Networks, Hospitals, State and Federal Governments and Communities to plan for sustainable general practice workforces in our regions.

1.2.3 MCCC Values

Respect Compassion Integrity Responsibility Innovation


Page 8 of 70

1.3 CEO welcomeCongratulations on choosing a career in general practice, and welcome to Murray City Country Coast GP Training (MCCC). Our region encompasses the western part of Victoria, extending from the South Australian border to Melbourne, and north to the New South Wales border near Corryong, taking in a small area of New South Wales near Holbrook.

One of our great strengths is the high quality of our education and training program for registrars. This is based on two key facets:

Learning occurs in-practice, where your supervisors are committed to both formal and informal teaching opportunities.

Learning occurs out of practice (face to face and a range of directed learning activities), facilitated and supported by our experienced team of medical educators.

As a registrar you are learning with a cohort of peers, enabling you to share your experiences, support each other and develop collegiate networks that will remain throughout your career. In addition to the support provided by the Medical Education team, your supervisors and your peers, you will have regular meetings with a Training Advisor (TA), who will provide individual guidance and mentoring. The Registrar Liaison Officer (RLO) is able to assist by providing information and is a further resource for assistance. As an MCCC registrar you will also be well supported by the skilled administrative team based in our four offices in Bendigo, Parkville, Warrnambool and Wodonga.

When you enter the AGPT program with MCCC, you enter a relationship of mutual obligation. We will provide a range of programs and funding to assist you to become part of your profession and we expect that you will treat that support with respect.

This relationship of mutual obligation involves a responsibility for you to:

Make yourself familiar with the contents of this Registrar Handbook.

Meet the requirements of the MCCC education program by fully participating in all educational activities.

Work with MCCC to ensure that administrative aspects of your enrolment with the Department of Health are addressed and maintained.

Treat MCCC staff, practice supervisors and staff, and, most importantly, the patients you care for with courtesy and respect.

Greg McMeelChief Executive Officer


Page 9 of 70

1.4 MCCC contact detailsGeneral enquiries

Phone 1300 6222 47 (1300 MCCC GP) Fax 03 9999 4558

Metro West

Postal Address

Level 2, 369 Royal ParadePARKVILLE VIC 3051

Street Address

Level 2, 369 Royal ParadePARKVILLE VIC 3051

Phone 03 9999 4540

RHE Dr Thanh [email protected]

REAPS

WorkshopCoordinator

Lynette O’Dwyerlynette.o’[email protected]

RLO Dr Jayde [email protected]

Lorraine O’[email protected]

North EastPostal Address

PO Box 165WODONGA VIC 3690

Street Address

Level 4, 111-113 Hume StWODONGA VIC 3690

Phone 02 6062 3800

RHE Dr Ursula [email protected]

REAPS

WorkshopCoordinator

Loretta [email protected]

RLO Dr Kate Rahman [email protected]

Isabelle [email protected]

North West

Postal Address

PO Box 1229BENDIGO VIC 3552

Street Address

PO Box 1229BENDIGO VIC 3550

Phone 03 4444 2300

RHE Dr Rachel [email protected]

REAPSWorkshopCoordinator

Lyn-Marie [email protected]

Terri [email protected]

RLO Dr Kiri Mathews [email protected]

South WestPostal Address

PO Box 5010 WARRNAMBOOL VIC 3280

Street Address

Level 1, 49 Kepler StWARRNAMBOOL VIC 3280

Phone 03 4505 2600

RHE Dr Margaret [email protected]

Dr Eldon [email protected]

REAPSWorkshop Coordinator

Jannah [email protected]

Merryn [email protected]


Page 10 of 70

mailto:[email protected]











RLO Dr Aik Honn [email protected]

MCCC-WIDERLO

Dr Radhika [email protected]

1.5 Important resourcesThe following websites provide valuable resources to inform you about your rights and responsibilities within the AGPT program.

www.agpt.com.au Australian GP Training Program website

www.acrrm.org.au Australian College of Rural and Remote Medicine

www.gpra.com.au GP Registrars Association

www.gpsa.com.au GP Supervisor Association

www.mccc.com.au Murray City Country Coast website

www.racgp.org.au Royal Australian College of General Practitioners

1.5.1 Pivotal: MCCC’s Online Administration Platform

MCCC has introduced an online registrar information management system called Pivotal. It has tools to assist you in developing a learning plan, links to resources and provides information to you, your supervisor and your training advisor. You can access Pivotal from the MCCC website – www.mccc.com.au. Your username and password will be sent to you by email early in your training.

1.5.1.1 Support for Pivotal

Help files will be available on the MCCC website.

Training activities will form part of your orientation program.

MCCC admin staff will provide one-to-one support in person, over the phone and by screen sharing.

Pivotal provides registrars with access to a web-based learning planner. An advantage of using this learning planner is that it is a permanent on-line record that can be viewed by your supervisor and MCCC's medical educators, such as Training Advisors. Registrars are entitled to use means other than the Pivotal Learning Planner to plan and document their learning. However, registrars must ensure that their plan for learning can be submitted to MCCC as an electronic document (e.g. a Word document, an Excel spreadsheet, a readable scanned document of a hand-written document, etc.).

Contact the MCCC office if you experience difficulties with Pivotal or forget your login details or email [email protected].

Important correspondence is sent from MCCC to registrars and entered through Pivotal.

Please ensure your address, phone and email details are always current on Pivotal throughout your training. Having your current information is also essential for


Page 11 of 70

http://www.mccc.com.au/

http://www.racgp.org.au/

http://www.mccc.com.au/

http://www.gpsa.com.au/

http://www.gpra.com.au/

http://www.acrrm.org.au/

http://www.agpt.com.au/



MCCC when pre-populating and printing your provider number applications.

MeL: MCCC’s Learning Management System

MeL is MCCC’s learning management system. This is where you will find:

Learning resources.

Pre- and post-workshop activities.

Assessment tasks.

1.5.1.2 Accessing MeL

Login via the MCCC website, using the My MCCC button.

Through your Pivotal portal.

Go there directly via http://mel.mccc.com.au.

Your username and password will be emailed to you early in your training.

1.5.1.3 Support for MeL

Introduction in your orientation program.

Email: [email protected] .

Call your local MCCC office and ask for MEL Help.

1.5.1.4 MCCC Website

Policies, procedures (accessed from the MCCC Website via My MCCC button)

This Registrar’s handbook

Forms other than those input via Pivotal

Resources – this section has a varied selection of documents to assist you throughout your training.


Page 12 of 70


http://mel.mccc.com.au/

2 MCCC’S educational approach

MCCC’s AGPT program is based on the traditional teacher-student or apprenticeship model of training developed over many years by RACGP and ACRRM. This on-the-job regime involves you working as an independent member of a practice’s medical team under the supervision of an accredited supervisor. The level of supervision is matched to your experience and learning needs. On-the-job (or in-practice) teaching and learning is augmented by the out-of-practice learning program. MCCC does not consider in-practice and out-of-practice learning as separate domains, rather that they are inexorably entwined, with registrars learning at work, from work, and for work.

MCCC’s approach to education is shaped by the following educational theories:

Work-based learning.

Situated learning.

Experiential learning.

An epistemology of practice.

Transformative learning.

Self-directed learning.

Education with MCCC is supported by a strong team culture where learning is a shared experience between you and the greater medical education team, including medical educators, supervisors, other practice staff, the Primary Health Care Network and your peers.

2.1 The medical education team

2.1.1 Director of Medical Education & Training (DMET)

The Director of Medical Educator & Training (DMET) works closely with all members of the medical education team, the Chief Executive Officer (CEO) and Chief Operations Officer (COO), the administration team, the Board and other stakeholders to ensure the education and training provided by MCCC meets the standards of both colleges, the requirements of the greater primary health care network and the needs of you, the registrar.

2.1.2 Medical Educators (MEs)

Our experienced and qualified Medical Educators have various educational roles within MCCC including:

The planning, implementation and review of the out-of-practice component of your learning.

Assisting you to develop and maintain an active plan for learning.

Sharing their skills, knowledge and experience.

Working closely with your supervisors and the greater education team, to support your learning across the entire program.

Medical Educators may also be Training Advisors or supervisors within a practice.


Page 13 of 70

MEs are organized into four regional teams, each with a lead Regional Head of Education (RHE). The DMET and RHEs work as part of a senior team to maintain the quality of education across the organisation.

2.1.3 Supervisors

Supervisors play a key role in registrar training. Your supervisor is an experienced general practitioner who works in a practice or post that has been accredited by either College. Your supervisor will provide on-the-job teaching, supervision and advice in line with the standards set by the RACGP and ACRRM. Details of the RACGP and ACRRM standards can be found on the respective college websites.

A schedule of accredited general practice supervisors, practices and other training posts in MCCC’s region can be found on the MCCC website.

2.1.4 Training Advisor Review Meeting

You will be allocated a Training Advisor to support you during your training. The contact might occur face-to-face, via telephone or other interactive technology. The role of the training advisor is to:

Help you to develop a whole of training career plan that addresses both clinical development and personal wellbeing when career choices are being made.

Assist you in completing applications for Recognition of Prior Learning (with or without time credit).

Oversee the development and review of your individual and specific learning plan and recording of those on Pivotal.

Provide mentorship / career guidance.

2.1.5 External Clinical Teaching Visitor

During your general practice terms you will receive a minimum of five (5) External Clinical Teaching Visits (ECTVs) conducted by a medical educator or an experienced GP supervisor. There will be at least two (2) visits per semester for GPT/PRRT 1&2 and one (1) per semester for GPT/PRRT3. Visits may continue into GPT4 as required. For ACRRM registrars, these ECTVs will form part of the formative miniCEX requirements.

During ECTVs the medical educator or visiting supervisor will observe you consulting in your practice and provide feedback and assist you to identify your learning needs. A written report will be available to you, your supervisor and your Training Advisor.

2.1.6 Registrar Liaison Officers (RLOs)

MCCC appoints a number of registrars as Registrar Liaison Officers (RLOs). RLOs maintain regular contact with GP registrars and facilitate their input into future development, implementation and evaluation of the training program. The RLO can be a point of contact for registrars who have questions or concerns regarding their training. They are also a link to, and are able to represent local registrars to, General Practice Registrars Australia (GPRA). There will be an RLO in your region whom you can contact via email (your regional office will provide details). You may also see them at your workshops.


Page 14 of 70

2.2 The education program

The AGPT program comprises both in-practice and out-of-practice learning and teaching opportunities.

2.2.1 In-practice

The MCCC in-practice education program includes all teaching and learning that happens in the training post. The in-practice program provides significant learning and teaching opportunities including:

Planned teaching sessions: one on one and small group.

Ad hoc teaching (colloquially known as ‘corridor teaching’ or ‘teaching on the run’, see Morrison, Clement, Brown, & Nestel, 2014).

Consultations with patients.

Working with your supervisor and other practice staff to develop and action your learning plan.

Contributing to educational events targeted at local communities, organised by your practice.

External Clinical Teaching Visits (ECTVs) /MiniCEXs/Case based discussions.

Training Advisor review meetings.

In-practice assessment, feedback and monitoring.

Teaching time from your GP supervisor (or other GPs in the Supervising team) will depend on your stage of training:

GPT1/PRRT1 3 hours in total per week* (pro rata for part time registrars) GPT2/PRRT2 1.5 hours in total per week* (pro rata for part time registrars) GPT3/PRRT3 45 minutes per week in total (NOT pro rata)

*This includes a minimum protected 1 hour block in the appointment schedules of the GP Registrar and GP Supervisor for GPT1&2/PRRT1&2

As the deliverers of in-practice (on-the-job) teaching and supervision, GP supervisors and the practice supervision team are the core to successful general practice training.


Page 15 of 70

2.2.2 Out-of-practice

The out-of-practice education comprises a series of Learning Programs, which align with the curricula from both RACGP and ACRRM.

These are:

GPT1-2/PRRT1-2

Learning Program 1: Initial Assessment and Orientation Learning Program 2: Core Skills 1 Learning Program 3: Emergency Skills Learning Program 4: Child and Adolescent Health Learning Program 5: Sexual and Reproductive Health Learning Program 6: Women’s Health Learning Program 7: Men’s Health Learning Program 8: Core Skills 2 Learning Program 9: Aboriginal and Torres Strait Islander Health Learning Program 10: Mental Health Learning Program 11: Chronic Disease Learning Program 12: Musculoskeletal and Procedural Skills Learning Program 13: Aged Care

GPT3/PRRT3

Learning Program 14 The Future

The details of each Learning Program will be available to you on the MCCC Website.

Attendance at all scheduled learning activities is compulsory. Please see ED0012 Out-of-Practice Education Attendance Policy

The Learning Programs detail learning activities that will occur in the following modes described below.

2.2.2.1 Face-to-Face

Teaching and learning that happens in person in the same physical space or supported by the use of real-time technologies. This might include: workshops, study groups, one-on-one coaching and mentoring and synchronous on-line learning (webinars).

Please note: There is a schedule of compulsory workshops. MCCC provides a detailed calendar of these workshops and other significant training events and dates. The education calendar is updated regularly and should be consulted frequently. It can be found on the MCCC website.

2.2.2.2 Directed Learning

Prescribed teaching and learning activities that you complete at your convenience. Directed learning may include pre-reading, background research, completion of online modules and review and reflection.

Please note: Directed learning activities might have a short timeframe (e.g. reading to be completed prior to a workshop) or a longer timeframe (e.g. an online module that must be completed by the end of a general practice term). In either case, you will be aware of the deadlines and critical dates in


Page 16 of 70

http://www.mccc.com.au/wp-content/uploads/2017/01/ED-0012-Out-of-Practice-Education-Attendance-Policy-v2.0.pdf


advance.

2.2.2.3 Self-directed learning

You will take the initiative in identifying and meeting your learning needs by implementing appropriate learning strategies. Self-directed learning activities will include the creation and maintenance of your active plan for learning which will include: reflection on learning needs, goal-setting, reviewing and updating a learning plan, attending an external course to meet an identified learning need, studying for examinations, and ongoing evaluation to ensure you are meeting your learning goals.

Please note: The scope of the RACGP and ACRRM curricula and the diversity of interests that registrars bring to the program mean that the major focus of the MCCC education program is on self-directed learning. The principle of self-directed learning is that the overall responsibility lies with you to plan your learning during your training. Workshops and other activities will only be able to address part of the curricula. You will need to address the gaps through your practice-based learning and your independent study.

2.2.2.4 Mental Health Skills Training

In order to acquire basic knowledge about management of mental health conditions and to gain access to specific MBS item numbers relating to the development of Mental Health Plans all GPs are required to undertake approved Mental Health Skills Training. From 2017 MCCC registrars are required to undertake an approved course prior to the face-to-face workshop on Mental Health in Semester 2, so the workshop can build on these skills.

Mental Health Skills Training (MHST)

Registrars are required to complete a General Practice Mental Health Standards Collaboration (GPMHSC) accredited MHST (Primary Pathway) in GPT1/PRRT1. The suggested timing of this is after the Core Skills 1 workshop. Registrars undertaking GPT1/PRRT1 in semester 1 are required to complete MHST by the end of their GPT1/PRRT1 term. Registrars commencing GPT1/PRRT1 in second semester are required to complete MHST prior to the MCCC Mental Health workshop in their region.Details of accredited mental health training courses are available from the colleges:

RACGP courses ACRRM’s Mental Health Disorders Training for Rural Practitioners

2.2.3 Your learning plan

A learning or training plan and, for ACRRM registrars, a logbook are crucial to your success as a self-directed learner. Both Colleges require you to develop and maintain a learning plan and a logbook of activities for presentation as part of your application for fellowship at the conclusion of your training. ACRRM registrars also require a training plan as part of their Recognition of Prior Learning application. Consequently it will be important to begin work on it as soon as possible and to ensure that it is documented. Your learning plan must be maintained in an electronic format of your choosing e.g. on a spreadsheet, Word document or template on Pivotal. ACRRM also provides a training plan template on its Resources page or via RRMEO.


Page 17 of 70

http://www.acrrm.org.au/training-towards-fellowship/overview-of-training-with-the-college/resources

http://www.acrrm.org.au/continuing-development/online-learning/virtual-classrooms/mental-health

http://www.racgp.org.au/education/gpmhsc/training/

Your Training Advisor and Supervisor can assist you to develop and maintain your learning plan and log book. You will need to present these from time to time and will need to keep them up to date. They will need to be lodged for final review at the time of your completion of training paperwork.

For further information please see policy ED0013 Management of Registrar Learning Needs and Learning Plans

2.2.4 Pastoral and Learning Support

During your time with MCCC there will be ongoing teaching, supervision, assessment and feedback. MCCC applies a fair and transparent processes of review throughout training to facilitate the early detection of problems and difficulties. It is possible that at some stage a specific problem may be identified with a registrar’s progress and competency.

MCCC’s Pastoral and Learning Support (PALS) team are a group of MEs from each region whose role is to ensure there is individualised support to assist registrars to achieve their learning goals and to meet training, education and assessment requirements.

Key to this process are the formative assessments that are undertaken at the beginning of your GPT1/PRRT1 and GPT2/PRRT2 terms as well as periodically through your training (See section 3.12). These assessments are used by your Training Advisor, your supervisor and the PALS team to determine whether you have attained the benchmark skills and attributes expected at your stage of training (see 4.3 Appendix C).

When a problem is identified, actions may include (but are not limited to):

A meeting with a Medical Educator and your supervisor to develop strategies to deal with the issue.

Following this, a focused learning intervention plan with agreed learning outcomes may be formulated.

If the identified learning needs require further intervention, you may be required to undergo formal remediation as required under the AGPT Remediation policy.

Please see ED0005 Registrar in Difficulty Procedure for further details

2.3 Registrar and family supportMCCC acknowledges that the transition to general practice can be challenging, from both a professional and personal point of view. To assist you with this process, MCCC offers the following resources:

Your Supervisor and Practice Manager.

Registrar Education and Practice Support Coordinator (one per region).

Registrar Liaison Officer.

Training Advisor.


Page 18 of 70

http://www.mccc.com.au/wp-content/uploads/2017/01/ED-0005-Registrar-in-Difficulty-Procedure-v1.0.pdf

2.3.1 Self-Care

MCCC believes self-care is essential for a practicing GP. Doctors support their patients’ health and wellbeing but often neglect their own. In order to assist our registrars and promote general wellbeing and functionality, MCCC includes the topic of self-care in its workshop programs. MCCC also provides a Registrar Assistance Program that enables you to access services. Please discuss this with the RHE in your region.

There are many ways for registrars to seek assistance if experiencing difficulty in any aspect of training or from a personal perspective, and we strongly encourage you to do so.

Please see ED0008 Registrar Wellbeing Procedure and MCCC’s self-care resources for registrars for further information.

2.3.1.1 Other Resources

Victorian Doctors Health ProgramA confidential compassionate service for doctors and medical students (or anyone concerned about a doctor) with health/drug and alcohol/mental health concerns. It operates independently from any other organisations. Tel: (03) 9495 6011

Doctors’ Health Advisory Service Independent service with calls handled by a panel of senior GPs experienced in helping colleagues. Tel: (03) 9349 3504 (VIC) or (02) 94376552 (NSW)

Bush Crisis LineConfidential and anonymous phone debriefing and counselling support service for remote health practitioners and their families. Run by qualified psychologists with rural/remote and cross-cultural experience. Tel: 1800 805 391

AMA Victoria Peer Support ServicePeer support for doctors – telephone counselling and referrals.PO Box 21, Parkville, VIC, 3052 Tel: 1300 853 338

RACGP Support Program for membersMembers can access professional advice to help cope with life’s stresses, which may include personal and work related issues that can impact on their wellbeing, work performance, safety, workplace morale and psychological health.

The service will advise of town location of the office addresses when ringing the number. The service is provided by IPS Worldwide.

IPS Worldwide ® Level 25, 303 Collins Street, Melbourne, VIC, 3000 Tel: 1300 366 789

2.3.2 Safety Promotion and Risk Management

2.3.2.1 Introduction

Although you are not employed by MCCC, the organisation has a responsibility to ensure that your safety and wellbeing is promoted and risk factors are minimized as far as practicable. MCCC’s Registrar Agreement details particular responsibilities for both the organisation and registrars enrolled with MCCC.

Registrar wellbeing is an intersection of the responsibilities of MCCC, accredited training posts, and


Page 19 of 70

http://www.mccc.com.au/wp-content/uploads/2016/01/Guidance-Document-Self-care-resources-for-registrars.pdf

http://www.mccc.com.au/wp-content/uploads/2017/01/ED-0008-Registrar-Wellbeing-Procedure-v1.0.pdf

the individual registrar. As employers of registrars, training posts have occupational health and safety obligations that are governed by Federal and State legislation. Both ACRRM and the RACGP set standards to ensure the occupational health and safety of a practice team1,2. Specific sections of The National Terms and Conditions for the Employment of Registrars (NTCER) similarly addresses issues related to the health and safety of registrars3.

2.3.2.2 Registrar Disclosure of Risk Factors

Acting on the advice of the Victorian WorkCover Authority, MCCC seeks to ensure that the following statement is disseminated widely:

Registrars are strongly advised to disclose and discuss with their supervisors any medical condition that might place themselves, or their patients, at risk. This is particularly important in view of the work patterns of registrars in different hospital rotations and general practice attachments.

Different shifts, rosters, after-hours and on-call duties are all aspects of the work that you need to be aware of and manage effectively. Discussion with supervisors will enable appropriate strategies for management of the work environment to minimize the potential for harm to yourself or your patients.

2.3.2.3 Fatigue Management

MCCC recognizes that fatigue is a potential workplace hazard that can affect your training. Fatigue has many implications for you personally, your ability to meet your education and training requirements and your capacity to provide safe, quality care for your patients.

Further information and management strategies can be found in these publications:

GPRA (2012) Fatigue Management in Vocational General Practice Training.

Safe Work Australia (2011) Preventing and Managing Fatigue in the Workplace.

2.3.2.4 Registrar Safety Training

Training in safety matters for registrars includes:

Recognizing high-risk situations.

What to do when feeling unsure or unsafe.

Dealing with angry patients.

Dealing with drug-seeking patients.

Personal self-care.

Matters relating to your safety are included in appropriate parts of the educational program.

2.3.2.5 Safety in the Clinic

1 Australian College of Remote & Rural Medicine. (2013). Standards for supervisors and teaching posts. Brisbane: Australian College of Remote & Rural Medicine.2 Royal Australian College of General Practitioners. (2010, updated 2013). Standards for general practices (4th edition). East Melbourne: Royal Australian College of General Practitioners.3 GPRA/GPSA/AMA (2014) The National Terms and Conditions for the Employment of Registrars (NTCER) 2015 & 2016 GP Training Years.


Page 20 of 70

There is a diversity of practices across the MCCC footprint. Consequently, in-practice safety procedures vary. It is essential that you familiarize yourself with the procedures in your own practice. This will be clarified during your in-practice orientation.

2.3.2.6 Safety After-Hours

As above, there is a diversity of practices and after-hour requirements. Your practice will have a procedure to ensure your safety in regard to after-hours work. It is essential that you familiarize yourself with this procedure.

2.3.2.7 Resources

These publications provide some useful guidance:

Clode, D. and Boldero, J. (2005) Keeping the doctor alive: A self-care guidebook for medical practitioners. Royal Australian College of General Practitioners, South Melbourne.

Rowe, L., Morris-Donovan, B. and Watts, I. (2009) General practice – a safe place: tips and tools. Royal Australian College of General Practitioners, South Melbourne.

2.3.2.8 Safety on the Road

While enrolled on the AGPT program, most, if not all, registrars will spend time driving. This may be to and from work, to workshops, or to other meetings facilitated by MCCC as part of your training.

MCCC recognizes that long distance driving poses a risk to registrar safety and consequently we discourage registrars from long-distance commuting and strongly advocate that registrars live in the community in which they work. Fatigue exacerbated by driving long distances is a significant risk to the registrar, patients and the training post, for which the registrar bears the largest responsibility. The Code of Conduct for Doctors in Australia states clearly that, “good medical practice involves recognizing and taking steps to minimize the risks of fatigue” (p.16)4.

2.3.2.9 Safety at ‘Out-of-Practice’ Educational Events

Your wellbeing at mandatory out-of-practice educational events (e.g. workshops) is the prime example of where health and safety responsibilities intersect, especially in relation to fatigue. Training posts, particularly in rural Victoria, may be a significant distance from the training venue. The NTCER is clear that a registrar’s roster should consider the issue of fatigue in relation to the distance that a registrar needs to travel to attend “educational releases” (section 16), and that a registrar should discuss fatigue management with the relevant person at the practice. Some safeguards might be: not being on-call the night before a workshop and allowing travel time to and from a workshop during work hours if the distance to be travelled is significant.

In 2017, registrars who are required to travel more than 80 km from their practice to a workshop may be offered accommodation paid for by MCCC. This is the case whether a workshop is scheduled for one or more days.

At the end of a workshop a registrar may be eligible for an additional night of funded accommodation if travelling home poses a risk to the registrar’s safety.

Eligibility may depend on:

4 Medical Board of Australia (2014) Good Medical Practice: A Code of Conduct for Doctors in Australia. Melbourne, Medical Board of Australia.


Page 21 of 70

Seasonal considerations (i.e. the amount of daylight).

The distance to be travelled.

The number of people travelling together to the same or close-by destination.

Arrangements with the registrar’s training post.

It is the registrar’s responsibility to initially discuss requests for paid accommodation with the relevant local Workshop Coordinator. (Note that MCCC does not pay registrar travel time/mileage/reimbursement to workshops or other educational events. Immediate family members may stay in any approved accommodation, but any associated additional costs are to be met by the registrar (e.g. cots for children, food, cleaning, etc.).

If an eligible registrar requests workshop accommodation and then does not use it or cancels it, the registrar may be required to reimburse MCCC for any costs incurred.

2.4 Confidentiality and privacyConfidentiality and privacy are used interchangeably in everyday talk, but they have distinctly different meanings from a legal standpoint.


Page 22 of 70

Definitions

Confidentiality Confidentiality refers to personal information shared with another person that typically cannot be divulged to a third party without the consent of the first individual. It is expected that information that is ‘held in confidence’ will only be shared after authorisation is provided, and only to authorised individuals.

Privacy Privacy refers to the freedom from intrusion into one’s personal matters and personal information. The boundaries around privacy are not tight, but include information or opinion about a person’s:

State of health.

Racial or ethnic origin.

Political, philosophical or religious opinions, beliefs or affiliations.

Membership of a professional or trade association or union.

Sexual preferences or practices.

Criminal record.

These are categories of ‘sensitive information’ under the Privacy Act 1988

Personal information

Information, or an opinion, about an individual, whose identity is apparent, or can be reasonably ascertained from that information or opinion, whether the information or opinion is recorded in a material form or not.

MCCC is committed to complying with Australian Privacy Principles, given in the Privacy Act 1988, and the privacy provisions of all applicable legislation (e.g. Privacy and Data Protection Act (Vic.) 2014). MCCC’s approach to confidentiality and privacy covers all personal information held by the organisation, including personal information sourced from third parties. MCCC will only collect, store, use and disclose personal information that it is permitted to by law.

All registrars will be provided with information in relation to their rights and responsibilities. This text is a key means to this end. Information will be provided to registrars regarding their personal information and what it will be used for. MCCC’s Registrar Agreement includes a privacy consent form that registrars are given and asked to sign at the commencement of their general practice training. Signing the registrar agreement allows MCCC to share training record information with other individuals that are involved in a registrar’s training (e.g. MCCC’s Medical Educators or a new supervisor).

Registrars will be assisted to access their information if required. Much of this information is available to an individual registrar via MCCC’s administrative management system (Pivotal). MCCC may need to deny access to information in accordance with the exemptions contained in the Privacy Act 1988.

A release of information form will be completed and signed by the registrar if information is to be sought from or provided to other agencies. Registrars may withdraw their consent at any time.

If MCCC collects sensitive information (as defined under the Privacy Act 1988) it will be treated with the utmost security and confidentiality. MCCC will ensure that it is not collected for any purposes other than those for which MCCC has obtained the individual’s consent, unless the law requires otherwise, or other exceptional circumstances prevail as described under the Privacy Act 1988.


Page 23 of 70

Where an individual chooses not to provide requested information, MCCC will advise that individual of what impact this may have. MCCC will only disclose personal information in accordance with the Privacy Act 1988. This means that personal information may be disclosed:

For the purposes for which it is being collected, and for related purposes that the individual would reasonably expect.

Where consent to do so has been given by the individual.

As part of the arrangements for training to be done by an outside organisation or individual.

As required by law.

Under other circumstances where permitted under the Privacy Act 1988.

In the course of its business and training activities, MCCC may need to disclose personal information to relevant individuals and organisations. Unauthorized disclosure of, or access to, personal information by MCCC employees, contractors or agents, will be regarded as a serious breach of policy. Appropriate action (which may include disciplinary or legal action) will be taken in such cases.

MCCC takes all reasonable steps to ensure that the data it collects is accurate, complete and up-to-date. The personal information collected by MCCC will be protected and managed confidentially and securely, and destroyed appropriately when no longer required.

2.5 The AGPT program

2.5.1 Professional recognition as a general practitioner

Doctors wishing to be vocationally registered as a general practitioner in Australia must gain Fellowship of the Royal Australian College of General Practitioners (RACGP) or the Australian College of Rural and Remote Medicine (ACRRM). The awarding of Fellowship comprises the successful


Page 24 of 70

completion of MCCC education program requirements and College-related summative assessments.

Successful completion of the Colleges’ assessments will not automatically lead to the awarding of Fellowship. This will be dependent upon the successful completion of all MCCC training requirements. The requirements will be acknowledged and signed off by the DMET.

The program offered by MCCC enables doctors to gain Fellowship through either or both Colleges. This enables doctors to become vocationally registered and consequently access full Medicare Benefit Scheme rebates for patients from Medicare Australia.

2.5.2 The roles of the two Colleges (ACRRM and RACGP)

MCCC collaborates with both Colleges to ensure the education and training program meets their Vocational Training Standards.

Please note:

RACGP and ACRRM set the curricula.

All MCCC training practices, training posts and supervisors are accredited to provide training (this accreditation may be College specific).

RACGP and ACRRM set the summative assessments.

In enabling you to meet the requirements of the Colleges, MCCC supports you to design an active and relevant learning plan to address your own personal needs and aspirations. You also have the opportunity to choose the qualifications that you wish to attain. Please note the information that follows regarding these qualifications and pathways.

2.6 Choosing a pathway

Once selected into the MCCC training program you will need to decide on training with either the RACGP or ACRRM or both.

You MUST become a paid member of the relevant College throughout your training. A


Page 25 of 70

delay in doing so will result in the College not recognizing any training time prior to your membership as part of your training time.

If you are an RACGP member and wish to undertake a 4th year of training (ARST) you must be enrolled in FARGP.

2.6.1 Training towards Fellowship of Royal Australian College of General Practitioners (FRACGP)

MCCC provides a comprehensive, high quality training program compliant with the requirements of the RACGP curriculum.

The RACGP pathway is a three (3) year program that includes an initial hospital year, eighteen (18) months of community-based general practice and six (6) months of training in a skills term relevant to your GP Training (this can be completed in general practice). During this period, MCCC runs peer learning workshops as well as working closely with GP supervisors to ensure all GP registrars receive appropriate experience, adequate teaching and mentoring.

2.6.1.1 Summary of training units and terms offered in RACGP training

Component of trainingNumber of 13 week active training units required Length of training

Hospital training 4 52 weeks full-timeGPT1 2 26 weeks full-timeGPT2 2 26 weeks full-timeGPT3 2 26 weeks full-timeGPT4 in GP or Extended skills 2 26 weeks full-time

The above compulsory terms can then be complemented by one of the following elective terms:

Advanced Rural Skills Post 4 52 weeks full-time

Academic Post will count towards an Extended skill

2 26 weeks full-time

2.6.1.2 Advanced training terms

The AGPT Program provides opportunities for all registrars to undertake a range of advanced terms, referred to as extended skills, advanced rural skills training (ARST), or academic posts. These are ideal for registrars with a special clinical interest. In some cases these experiences can lead to postgraduate qualifications.

The curricula of the FRACGP and FARGP have different requirements for elective training and rural


Page 26 of 70

specialized training. MCCC offers training packages that meet the requirements of these awards, which can be tailored, to your particular needs or interests.

MCCC requires you to apply for Extended Skill posts a minimum of three (3) months prior to your proposed commencement date in that post. Training time in these posts will not be recognized unless pre-approved by MCCC.

From 2017 onwards a term in general practice must be completed prior to commencing an Extended Skill with the following exceptions: DRANZCOG, JCCA and the Diploma in Palliative Care.

2.6.1.3 Extended Skills Training

MCCC has a range of accredited Extended Skills Posts at various locations. These include (but are not limited to):

Aboriginal Health Emergency

Mental Health Obstetrics & Gynaecology (Dip. Obs)

Palliative Care Sports Medicine

Alpine Skills

Small Town General Practice

Correctional Medicine

Paediatrics

Sexual Health/HIV medicine

Forensic Medicine

Family Planning

Medical Education

2.6.1.4 Training towards Fellowship in Advanced Rural GP (FARGP)

The FARGP pathway is an additional non-vocational qualification that can be added to the three (3) year RACGP pathway. It involves an additional year of training undertaking an Advanced Rural Skills Training post (ARST), including mandatory learning modules and educational activities.

Registrars interested in training towards the FARGP are advised to discuss this with their training advisor at the earliest opportunity.

The following ARST posts are offered through MCCC:

Aboriginal Health Obstetrics & Gynaecology (DRANZCOG Advanced)

Anaesthetics Small Town General Practice

Mental Health Emergency Medicine

2.6.1.5 Academic Posts

MCCC is associated with a number of university campuses. Opportunities exist to become an academic registrar within the training program. If you have an interest in this area, please contact


Page 27 of 70

the MCCC office or speak to your Training Advisor. Further information can be located on the AGPT website.


Page 28 of 70

2.6.2 Training for Fellowship of Australian College of Rural Remote Medicine (FACRRM)

MCCC provides training in rural and remote medicine. Many of our supervisors and medical educators have a high-level of experience in providing extended generalist care in relatively isolated settings, including small rural hospitals, providing procedural services in the fields of anaesthetics, obstetrics and emergency medicine. MCCC is able to offer registrars unique training opportunities in these fields and other areas relevant to rural practice.

ACRRM training is modular and flexible but does require registrars to undertake training in accredited locations and complete required assessments during training.

In order for MCCC to optimally assist potential ACRRM registrars it is necessary for early meetings with an ACRRM training advisor to take place. This is to plan the training journey and assist registrars in completing their training in a timely way. Failure to do so may mean the registrar may not have sufficient training time in AGPT to complete the ACRRM pathway and assessments.

The ACRRM training pathway is a four-year program. It consists of:

ACRRM VOCATIONAL PREPARATION PROGRAM FOR REGISTRARS

Core Clinical Training (CCT) Primary Rural & Remote Training (PRRT)

Advanced Specialised Training (AST)

12 Months 24 Months 12 Months

In an ACRRM Accredited Hospital Terms:

General Medicine

Obstetrics & Gynaecology

Anaesthetics

General Surgery

Paediatrics

Emergency Medicine

You can commence without O&G, Anaesthetics or Paediatrics, but they must be met during PRR training or through an AST.

Minimum 6 months in primary/community care.

Minimum 6 months in hospital/emergency care.

Minimum 12 months rural/remote experience in any of the following:

Rural Hospital

Aboriginal Medical Service

Rural Generalist Practice

RFDS

Only one is required, of the following:

Academic Practice

Adult Internal Medicine

Anaesthetics

Emergency Medicine

Indigenous Health

Mental Health

Obstetrics & Gynaecology

Paediatrics

Population Health

Remote Medicine

Surgery

Please note that these PRRT and AST terms can be undertaken in any order.

Recognition of Prior Learning (RPL) may be awarded by ACRRM for part of this training time. Please refer to the section on RPL. It would be usual for RPL to be awarded for CCT.

For more information, please phone ACRRM on 1800 223 226 or go to the ACRRM website at www.acrrm.org.au . Please speak to your training advisor early if you are interested in this pathway.


Page 29 of 70

http://www.acrrm.org.au/

You must be a fully paid member of ACRRM to access the required training modules and fellow through this College.

Those registrars intending to follow the ACRRM pathway are encouraged to join ACRRM during their hospital time. This is especially relevant to enable adequate time to complete the relevant ACRRM assessment tasks, including the Procedural Skills Logbook.

The following Advanced Skills Training posts are offered through MCCC:

Aboriginal & Torres Strait Health Obstetrics & Gynaecology (DRANZCOG Advanced)

Anaesthetics

Mental Health

Remote Medicine

Paediatrics

Emergency Medicine

Surgery (2 years)

Adult Internal Medicine

Population Health

ACRRM registrars can complete an academic post as part of an AST in Academic Practice, Population Health, Remote Medicine or Indigenous Health.


Page 30 of 70

3 The registrar’s journey3.1 Hospital TermsBefore commencing training in general practice through either college, it is mandatory that registrars will have completed a minimum of twelve (12) months full time equivalent (FTE) in an appropriately accredited Australian hospital setting after internship or successful completion of the AMC Part 2 examination.

During the hospital year of training, the registrar will be employed by the hospital or area health service. The onus is on the registrar to find suitable hospital employment. MCCC cannot assist you in finding employment in the hospital system; however MCCC staff are available to provide guidance on the suitability of a particular post.

MCCC encourages registrars to undertake this hospital experience within its region wherever possible.

Those registrars who are entering the training program after extensive experience in hospital medicine may be able to gain recognition of this experience and exemption from the hospital terms by applying for Recognition of Prior Learning (RPL). Registrars on either College pathway must complete and submit their RPL documentation according to the relevant College’s RPL policy. MCCC has resources available to assist you in applying for RPL, including your REAPS, your Training advisor and the Medical Education team.

Rotations ACRRM RACGP

Core rotations (min. 10 weeks) Medicine, Surgery and Emergency

College-required rotations (min. 10 weeks)

Paediatrics*

Anaesthetics and O&G

These can be obtained during training.

Paediatrics (Mandatory)

Encouraged to have three rotations relevant to general practice, to provide adequate breadth of experience.

* Please note ACRRM registrars entering the program without Paediatrics, will be unable to change into the RACGP pathway at any stage during their training without completing this requirement. MCCC highly recommends that a Paediatric term be undertaken prior to commencing training.

ACRRM registrars can obtain their experience in Anaesthetics and Obstetrics via a variety of methods, including an AST year, attendance at suitable approved courses, short placements in hospitals and in rural community terms and completion of on line modules. See ACRRM website for more information.

ACRRM registrars require satisfactory completion of a number of Emergency Courses throughout training. Registrars placed in regional and rural settings are offered the REST course as part of the MCCC program.

Registrars must also have completed one year of hospital rotations. Only rotations undertaken after completing PGY1 or after completion of the AMC Part 2 examination can be counted.

3.1.1 Mandatory Paediatric Training


Page 31 of 70

Registrars must undertake hospital-based experience caring for a sufficient number of paediatric patients prior to undertaking a term in general practice. Such posts must include a high proportion of paediatric emergency attendances managed under appropriate supervision.

These posts are usually a hospital-based general paediatric post or a placement in an emergency department with a significant load of at least 20% (RACGP) or 25% (ACRRM) of acute paediatric presentations.

For further information, visit the relevant College’s Paediatric Policies.

3.1.2 Hospital Training (RACGP)/CCT (ACRRM) Requirements

Requirements Hospital Training/Core Clinical Training (CCT)

Paediatric Requirement Completion paediatric training evidence form before commencing training.

Disciplines Statement of Service listing all rotations dates and any leave taken in the period.

Hospital Registrar education program Teleconferences/webinars as arranged.

Assessment Reports

Submit HMO assessment or hospital supervisor report at the end of each rotation completed during hospital training/CCT year.

Training Advisor/ Review Meetings As required.

3.1.3 Hospital Registrar Education Program

MCCC has a cohort of registrars who are completing their hospital terms across all MCCC regions and in hospital settings across Australia. MCCC values the role of the hospital registrar as a pathway into general practice and, as such, develops programs and strategies to assist in the transition from the hospital environment to general practice.

The MCCC Hospital Registrar Program is for pre-general practice registrars who have not yet commenced GPT1. If you are a registrar completing your hospital terms, you are expected to participate in the Hospital Registrar Education Program.

This will consist of a face to face (or Skype) meeting at the beginning of each semester and four webinars throughout the year (two per semester)

MCCC will make contact with you in February with further information and details regarding the Hospital Registrar Education Program.


Page 32 of 70

3.2 Practice readyTo be considered practice ready you need to:

Have completed one (1) year of hospital rotations in addition to and after completing PGY1 or both parts of the AMC Part Two examination.

Completed all core rotations and show a breadth of experience (3 other GP related disciplines) in approved hospitals.

Hold full registration for a period of 12 months.

All RACGP candidates must have a current ARC-accredited CPR certificate when commencing their GPT1 term, and proof must be provided. CPR must remain current throughout training.

3.2.1 Being Matched to a Practice

Registrars are allocated to practices through a practice match process.

Registrars and practices are invited to apply for the practice match and confirm their participation in the match. Registrars will be notified by email when the practice match commences, along with guidelines and a list of available practices.

Registrars apply to practices and practices will subsequent select from these applicants for interview. Following the interview period, which lasts approximately five weeks, registrars and practices submit their preferences and the matching process is activated. Notification of the practice match outcome is made to registrars and practices. Further matches will be undertaken if necessary.

Practice matching is a complex process that endeavors to address the requirements of practice supervisors and registrars. There is no facility to accommodate registrar and practices making a private arrangement for a placement.

Further information becomes available before a match is opened.

3.2.2 What to do prior to commencing a GP Term

Once you have been matched to a practice, contact the practice manager and supervisor, at least two (2) months before term begins. Ideally, meet face-to-face prior to commencing at your practice. Discuss employment terms and conditions.

MCCC recommends that accredited teaching practices in our region use the National Terms and Conditions for the Employment of Registrars (NTCER) to develop contracts with registrars undertaking GP training.

Download the 2017 NTCER here.

A template contract which is compliant with the NTCER is available here .

Visit the GPRA website for more details.


Page 33 of 70

If you are using an alternative award or agreement to develop a contract with a registrar at your practice, it must comply with the minimum standards outlined in the 2017 NTCER.

Please use caution if deciding to utilise Awards or Enterprise Bargaining Agreements to which your practice may not be a respondent such as the Victorian Public Health

https://gpra.org.au/

https://gpra.org.au/employment-agreement-template/

https://gpra.org.au/national-terms-and-conditions-for-the-employment-of-registrars/

https://gpra.org.au/national-terms-and-conditions-for-the-employment-of-registrars/

As soon as you are advised of your placement the following paperwork must be attended to:

3.2.2.1 Registrar to provide to Practice

Current certificate of medical registration from Medical Practitioners Board.

Proof of adequate current Medical Indemnity Insurance (including procedural if required).

Provider number (refer below).

19AB exemption (entitlement to Medicare benefits), if appropriate.

Tax File Number declaration form.

Details of nominated superannuation fund and fund membership number.

3.2.2.2 Practice Manager to provide to registrars

Contract and other appropriate forms for signing.

Tutorial for practice software.

Password for billing.

Documents supporting VMO application process (where applicable).

3.2.3 How to acquire provider numbers

Prior to your first placement in general practice it is vital that you have a Medicare provider number (a number specific to each site in which you will practice). This gives you access to Medicare payments. Without it you cannot be paid. Medicare cannot and will not backdate applications received after you have commenced work.

MCCC will provide you with a pre-populated placement form for each provider number you are required to obtain.


Page 34 of 70

These forms can take up to 28 days to process.

You need a provider number for every location you work in.

If you change practices a new application is required.

The provider number has an expiry date and you must reapply as required.

Any delay may mean you are unable to commence work, as you cannot bill Medicare.

Applying and following up provider numbers is the registrar’s responsibility.

If you are using an alternative award or agreement to develop a contract with a registrar at your practice, it must comply with the minimum standards outlined in the 2017 NTCER.

Please use caution if deciding to utilise Awards or Enterprise Bargaining Agreements to which your practice may not be a respondent such as the Victorian Public Health

3.3 Recognition of prior learningIn order for RPL to be granted the following criteria must be met:

As the applicant, you must have been unconditionally medically registered in Australia for the entire period.

RPL with Time Credit is only applicable after full registration.

As the applicant, you must provide satisfactory documentation from the employing hospital of your hospital experience relating to the period for which RPL is being sought, together with references or supervisor reports where required.

Please note:

Applications for RPL are made on the appropriate form, available from MCCC administration staff.

RPL applications should be discussed with your training advisor.

Applications are assessed by MCCC medical educators according to AGPT, ACRRM and RACGP guidelines.

RPL can also be used for Extended Skill Training.

RPL applications must include a portfolio of documentation to provide evidence of the relevance of their prior learning to the learning objectives of training.

RPL will only be approved by the RHE and DMET if satisfactory progression of training has been demonstrated.

The process for application of RPL differs for each college. MCCC staff will assist you with the relevant details.

3.3.1 Recognition of prior learning without time credit

Recognition of Prior Learning without time credit:

Is RACGP specific.

Ensures recognition is recorded of mandatory hospital rotations.

Does not reduce training time.

Can only be applied for post intern hospital training experience.

For further information please refer to the following documents:

3.3.1.1 Further information about RACGP RPL

Recognition of Prior Learning policy

Applying for Recognition of Prior Learning Guidance Document

3.3.1.2 Further information about ACRRM RPL


Page 35 of 70

http://www.racgp.org.au/download/Documents/Policies/Assessment/2015/Applying-for-Recognition-of-Prior-Learning-Guidance-Document.pdf

http://www.racgp.org.au/download/Documents/Policies/Assessment/policy-recognition-of-prior-learning.pdf

Apply for RPL after you have obtained a training position.

ACRRM RPL allows for time on limited registration to be applied for.

RPL can also be used for Advanced Skills Training.

Submit the application through MCCC, who will check that the application is complete and has the required supporting documentation. MCCC will then make a recommendation for RPL and submit the application to the College. MCCC will consider all RPL applications on its merits, allowing for factors such as allowing attendance at its mandatory learning activities, the AGPT training time cap and allowing sufficient time to sit and pass mandatory assessments.

ACRRM RPL Application Form .

For further information, read the Fellowship Training Handbook .

3.4 Commencement of Training The MCCC calendar is available in Pivotal, which provides information on current semester dates. Information on out-of-practice workshops for the year is also made available on the MCCC website.

3.5 Practice OrientationA thorough orientation to your practice is essential. This is usually provided by the practice manager, practice nurse and supervisor, and in most practices a combination of the three. Especially for GPT1 registrars, the orientation process might occur over a series of days rather than all at once.

For GPT1 registrars, it is suggested that at least the first day in general practice be spent in orientation, sitting in with supervisor consultations and the first formal teaching session. You are likely to need some time with the practice manager as well, to ensure paperwork (e.g. provider number, prescriber number and insurance) is complete. Depending on your experience, a plan for when you will see your first patients and the timing of bookings can be made.

Please see Appendix B for a detailed checklist of what you can expect in your practice orientation.

3.6 GPT1, 2 & 3 (RACGP) or PRRT1, 2 & 3 (ACRRM) registrarsThese terms focus on the transition from tertiary care to primary care. Registrars will consolidate and increase skills in the general practice environment. These terms must be in an accredited teaching practice with MCCC over an 18-month (FTE) period.

Registrars receive direct supervision and teaching from the accredited supervisors. There is expected to be a high level of supervision, graduated responsibility and an increasing patient load. An orientation will be given at each new practice.

3.7 Training Time Calculations


Page 36 of 70

http://www.acrrm.org.au/docs/default-source/documents/training-towards-fellowship/handbook-fellowship-training.pdf?sfvrsn=12

http://www.acrrm.org.au/docs/default-source/documents/training-towards-fellowship/rpl-form-agpt-rvts-october-2013.docx?sfvrsn=2

All registrars commence their vocational training at 1.0 FTE and are supported to undertake full-time training to obtain College Fellowship. Any arrangement for the provision of training at less than 1.0 FTE is subject to negotiation between a registrar and MCCC.

3.7.1 Full Time Training

Training requirements are mandated by the relevant College and AGPT. The full time registrar training requirement is calculated at a minimum of twenty-seven (27) hours face-to-face consultation time over a four-day period per week.

Work periods of less than three (3) consecutive hours, or of less than one (1) month in any one practice will not be considered. Hours worked beyond this definition of full time will not be considered.

3.7.1.1 Full time training breakdown

Term Minimum Consulting face to face (Training time)

Teaching time (In paid time)

Educational Release (in paid time)

Admin time

(In paid time)

GPT1/PRR1 27 hours 3 hours 3.5 hours 2.5 hour

GPT2/PRR2 27 hours 1.5 hours 1.75 hours 2.5 hour

GPT3/PRR3 27 hours 0.75 hours 0 hours 2.5 hour

ES/PRR4/Elective 27 hours 0 hours 0 hours 2.5 hour

Please see important note on following page relating to the difference between employment time and training time.

Please note: Full time training is different than full time employment.

Full time employment is based on the National Terms & Conditions for the Employment of Registrars (NTCER), which states full time employment to be thirty-eight (38) hours a week averaged over four weeks.

3.7.2 Part Time Training

RACGP specifies a minimum of 10.5 hours face-to-face consultation time over a two-day period. Work periods of less than three (3) consecutive hours, or of less than one (1) month in any one practice, will not be considered by RACGP.


Page 37 of 70

Registrars seeking fellowship of RACGP cannot train at less than 0.3 FTE as per the College requirements.

Registrars seeking fellowship of ACRRM are not encouraged to train at less than 0.5 FTE per College requirements.

Teaching time for GPT1 & GPT2 is a minimum of one (1) hour regardless of FTE. Participation in the educational release workshops should be as per a full time registrar.

3.7.2.1 Part time training breakdown

Term Minimum Consulting face to face (Training time)

Teaching time (In paid time)

Educational Release (in paid time)

Admin time

(In paid time)

GPT1/PRR1 10.5 hours 3 hours pro-rata 3.5 hours as per F/T program 2.5 hour pro-rata

GPT2/PRR2 10.5 hours 1.5 hours pro-rata 1.75 hours as per F/T program 2.5 hour pro-rata

GPT3/PRR3 10.5 hours 0.75 hours 0 hours 2.5 hour pro-rata

ES/PRR4/Elective 10.5 hours 0 hours 0 hours 2.5 hour pro-rata

Please refer to the AGPT, RACGP and ACRRM policies for further information

3.8 Supervision Requirements Term Onsite Availability Availability by phone

GPT1/PRR1: 1st month100% consulting time* 0%

GPT1/PRR1: remainder 80% 20%

GPT2/PRR2 50% 50%

GPT3/PRR3 25% 75%

ES/PRR4/Elective 25% 75%

*This is preferred but not mandated


Page 38 of 70

GP Term Ave Patients per Hour

Max Patients per Hour

Min No Consults FTE week*

Max No Consults FTE week

GPT1 1st 3 months 2-3 4 50 90

GPT1 2nd 3 months 3-4 4 50 100

GPT2 3-4 5 60 110

GPT3+ 3-4 5 60 110

3.9 Patient Numbers

Registrar workload needs to be monitored to ensure they are not seeing too many or not enough patients. It is anticipated that the step up to increased patient numbers will be done in consultation with the registrar and supervisor.

3.10Registrar training and consultation information (RCTI)Registrar workload is recorded in the monthly Registrar Teaching and Consultation Information record (RTCI) in Pivotal. An overview of the RCTI process will be provided at the orientation workshop. For more information on the RTCI process, visit the Pivotal website.

3.11Diversity of Practice Experience (RACGP Ruling)All RACGP registrars must have experience in more than one practice in their training. This will involve a full six-month semester at another practice.

Any exemption from this requirement will need to be assessed on an individual basis by your local RHE and the DMET, and will require substantiated evidence as to why the exemption is required. The RACGP Censor will give final approval. Please refer to the RACGP policy for further information.

3.12Assessments

The MCCC General Practice Learning Program features assessment that is formative in nature and occurs throughout the program, and summative which is facilitated by the respective colleges.

Formative Assessment is embedded in the teaching and learning program, enabling feedback that is timely, relevant and enhances learning. It will draw on a range of methods appropriate to context and purpose, supporting continuous development of skills, knowledge and behaviours. The assessment processes reflects the standards of both Colleges and the Department of Health. In this way, formative assessment will inform entrance to, and progression through, the different terms. It also will allow opportunities for educational enhancements such as interventions, remediation and extension to the learning activities and experiences for each registrar.


Page 39 of 70

Summative assessment measures whether a particular level of competence or performance has been reached at a particular point in time. Summative assessment is the assessment registrars undertake with their chosen college (ACRRM or RACGP). Registrars undertaking joint pathways will be required to pass the assessments of both colleges.

Please see the table on the following page for further details.


Page 40 of 70

The following table summarises the formative assessments undertaken during your training.

Activity Brief overview GPT1/PRR1 GPT2/PRR2 GPT3/PRR3 ESP/PRR4

Initial Assessment

(RACGP and ACRRM)

This assessment is completed early in the GPT1/PRRT1 term and includes an MCQ and performance in clinical scenarios at orientation workshop. A supervisor report, a practice manager report and initial ECTV is also required

Assessments completed by the 6th week – discussed week 8

Further assessment

(RACGP and ACRRM)

This assessment is completed early in the GPT2/PRRT2 term and includes MCQ, DISQ patient survey#, ECTV, supervisor report and practice manager report

Assessments completed by the 8th week- discussed week 10

ECTV

(RACGP and ACRRM)

Apart from the Initial ECTV, the remaining visits are to be organised by the Registrar.

Contact the ECT visitor on the roster provided, for your subsequent visits.

Two visits per 6 months*

1st ECTV to be conducted within 6 weeks of commencing training.

Two visits per 6 months, the first of which forms part of the further assessment above*

One visit per 6 months*

Additional visits maybe required at the discretion of the Medical Education team.

MiniCEX

(ACRRM registrars only)

For 2017, formative MiniCEX will be undertaken by all ACRRM registrars

Five required by the end of PRRT Year One.

A total of nine completed by the end of Year Two.

Supervisor Feedback(RACGP and ACRRM)

Feedback provided to the RTO on the registrars progress.

A minimum of two (2) per semester

Registrar Feedback

(RACGP and ACRRM)

Feedback from the Registrar about their training

One per semester

One per semester

One per semester

One per semester

Training Advisor Review Meeting

(RACGP and ACRRM)

You will be allocated a Training Advisor.

The TA will conduct a Review Meeting with each registrar. The timing of these visits will be determined on an individualised basis. Minimum one per semester.

Learning Plan

(RACGP and ACRRM)

A Learning Plan is developed with the supervisor in MCCC.

A well maintained learning plan is required for completion of training.

At the start of each semester A specific ESP Learning Plan is developed with the supervisor.

Other Activities

RRMEO Modules (ACRRM only)

Online learning modules for ACRRM registrars only

Completion of four RRMEO modules during training (these are part of ACRRM summative assessments)

A list of recommended modules is available on RRMEO


Page 41 of 70

http://help.southerngptraining.com.au/wp-content/uploads/2014/01/Learning-plan-ADT-2015.pdf

# ACRRM registrars will also undertake the Colleague Evaluation Feedback Tool (CFET) at the same time in order to complete requirements for ACRRM summative multi source feedback* FTE: part time registrars will have 2 visits per 6-month full time equivalence.

3.12.1 Initial Assessment (GPT1/PRRT1)

As part of the formative assessment program, you will be involved in an Initial Assessment Process.

The purpose of the Initial Assessment Process is for the Medical Education Team to work with you, generating and collating information about your areas of strength, learning needs and capacity to perform at an expected GPT1 level. For further information see the Resources section on the MCCC website.

This Initial Assessment Process includes the following activities:

Consideration of your results in the Situational Judgement Test/ Candidate Assessment Applied Knowledge test from entry into GP training.

Completion of a Multiple Choice Questionnaire (MCQ).

Participation in clinical scenarios at the orientation workshop.

External Clinical Teaching Visit (to be completed in the first six (6) weeks of term).

Early Supervisor Assessment (to be submitted by week 6 of term)

Practice manager report (to be submitted by week 6 of term).

The information generated and collected will be used by the Medical Education Team to work with you and guide your learning journey, including the level of supervision and support, and to assist you to develop and actively use a relevant, documented plan for your learning.

3.12.1.1 Situational Judgement Test (SJT), Candidate Assessment Applied Knowledge Test (CAAKT) Score

The SJT/CAAKT is a written paper assessing your clinical reasoning ability. You completed this as part of the selection process. The Education Team will use your results to assist you in your learning and planning for learning.

3.12.1.2 Multiple Choice Questionnaire (MCQ)

The MCQ provides an opportunity for you to provide evidence of your general practice declarative knowledge and for the Education Team to continue to build a picture of your capacity and learning needs. The MCQ will consist of one hundred and forty (140) questions in single best answer (SBA) format. The MCQ will be completed online, in your own time, prior to the orientation workshop. Questions are in topic batches with a time limit attached to each batch. Once a batch of questions is opened it has to be completed in that sitting. You will receive feedback on completion of the MCQ with results against curriculum areas. You will receive further information from your regional office regarding dates, accessing the questions and trouble shooting.

3.12.1.3 Clinical Scenarios

Clinical scenarios are completed during the orientation workshop, and are an opportunity for:


Page 42 of 70

http://www.mccc.com.au/mymccc/resources/


You to demonstrate your knowledge and skills relating to the scenario.

The medical education team to gather information that will further contribute to understanding your strengths and learning needs.

You will receive feedback from a medical educator following each scenario.

3.12.1.4 External Clinical Teaching Visit (ECTV)

ECTVs are a learning opportunity for you to receive teaching and feedback on your consultation skills. The first ECTV is completed in-practice during initial assessment. You will be visited by a Medical Educator or experienced supervisor from a practice other than yours. They will observe a series (approximately six) of your consultations. This initial ECTV visit will occur in the first six (6) weeks of your time in practice. It is an excellent opportunity for you to talk with an experienced GP and educator about your consultations and receive valuable feedback. The ECTV provides MCCC with an opportunity to ensure that you are receiving the appropriate supervision required when you are working in practice.

3.12.1.5 Supervisor Report

The supervisor report is completed in practice during initial assessment, and involves your primary supervisor reviewing your performance via a combination of inputs. Your supervisor might choose from a variety of methods to assess your performance, including direct observation, WAVE consulting, completion of an observation checklist and case discussion. Your primary supervisor will complete this report by the end of your sixth week in practice. Again, the purpose of this is to assist you in identifying your learning goals and developing strategies to achieve those goals.

3.12.1.6 Practice Manager Report

Your practice manager is asked to collate information about you from practice staff (e.g. reception, practice nurse etc.) about how you are settling into to the practice.

Please note you will receive further detailed information about each of these assessment opportunities during the orientation period. This provides you with an overview of the process.

Feedback of performance in the Initial Assessment

The Medical Education Team will use the information gathered through the initial assessment process to ensure you have the appropriate level of supervision, assist you to develop an active learning plan and guide your learning journey at MCCC

Following all of these events, your results will be collated, summarised and discussed at a meeting of MEs in your region. A copy of the summary will be given to you to discuss with your training advisor (TA) at a meeting at approximately week eight of the term. Your supervisor will also receive a copy following this meeting and you are strongly encouraged to discuss this with your supervisor in addition.

If any actions as a result of your initial assessment are suggested by the ME team, then you will be informed and this will be discussed at the TA meeting.

You will find a copy of competencies expected at certain points in GP training on the MCCC website and as an appendix to this handbook.


Page 43 of 70

3.12.2 Further Assessment (GPT2/PRRT2)

MCCC undertakes a further assessment at the beginning of your GPT2/PRRT2 term in order to

help you identify learning gaps and add to your learning planner

give you feedback on how you are performing and progressing through training

help identify registrars who may benefit from extra support

For further information see the Resources section on the MCCC website.

The further assessment occurs within the first 8 weeks of the GPT2 term. It includes

3.12.2.1 MCQ

Completed online on MEL in your own time in the week before and after commencing GPT2/PRRT2. There are 140 questions (SBA) pitched at FRACGP level. Questions are in batches on topic areas and are time limited. Batches can be completed individually.

3.12.2.2 A DISQ (Doctors Interpersonal Skills Questionnaire).

DISQ is administered by Client Focused Evaluations Program (CFEP). They send out 40 questionnaires to the registrar with instructions on how they must be administered in week 2 of the GPT2/PRRT2 term.

Patients will be asked by your reception staff to complete them anonymously after seeing you. RACGP registrars:

A minimum of 30 (preferably 40) forms need to be returned to CFEP by the end of week 6 so they can collate results and send a report back to you and to MCCC comparing your results to your cohort. Written reflection on your report is recommended and you are expected to show and discuss your report with your supervisor.ACRRM registrars:

A minimum of 30 (preferably 40) forms need to be returned to CFEP. ACRRM registrars are compared with the wider ACRRM cohort as the DISQ is used as part of the ACRRM summative multi source feedback (MSF) assessment. ACRRM registrars will complete the Colleague Feedback Evaluation Tool (CFET) following the DISQ.Written reflection on the results is mandated for ACRRM registrars as part of their MSF requirement. The MSF report for ACRRM registrars is unlikely to be available in the further assessment timeframe and will be discussed with the registrar once available.

3.12.2.3 ECTV

An early external clinical teaching visit will be arranged for an ME to visit and sit in on consultations. The ME will observe you consulting and provide feedback. This will occur between weeks 6-8.


Page 44 of 70


3.12.2.4 Supervisor report

The supervisor report is completed in practice during the further assessment, and involves your primary supervisor reviewing your performance via a combination of inputs. Your primary supervisor will complete this report by the end of your eighth week in practice.

3.12.2.5 Practice manager report

Your practice manager is asked to collate information about you from practice staff (e.g. reception, practice nurse etc.) about how you are settling into to the practice.

Feedback of performance in the Further Assessment

Following all of these events, your results will be collated, summarised and discussed at a meeting of MEs in your region. A copy of the summary will be given to you to discuss with your training advisor (TA) at a meeting, approximately week ten of the term. In addition, your supervisor will also receive a copy following this meeting and you are strongly encouraged to discuss this with your supervisor.

If any actions as a result of your further assessment are suggested by the ME team, you will be informed and this will be discussed at the TA meeting.

You will find a copy of competencies expected at certain points in GP training on the MCCC website and in Appendix C of this handbook.

3.12.3 ECTV

As discussed above, ECTVs are a learning opportunity for you to receive teaching and feedback on your consultation skills. You will be visited by a Medical Educator or experienced supervisor from a practice other than yours. They will observe a series (approximately six) of your consultations.

3.12.3.1 Arranging your External Clinical Teaching Visit (ECTV)

This visit is as previously described in the Initial Assessment section, however it is the Registrar’s responsibility to arrange these subsequent ECT visits. Your practice manager may also be able to help.

You will be given an ECT roster, allocating a visitor to you; it will have their preferred contact email.

Email your ECT visitor to arrange a suitable time, provide them with your work hours to help you both find a suitable time.

Once your visit has been arranged, please email the TSO (details will be provided) with the date of this visit. This will be uploaded to Pivotal.

A confirmation email will come out from the MCCC to all concerned, so your practice blocks out this session accordingly.

Your practice will be asked to program your session with 30-minute appointments to allow for discussion with your visitor. Please check this has occurred.

All your patients must sign Consent Forms (available on MCCC website) before their consultation.


Page 45 of 70

Remind your reception team of this requirement on the day.

3.12.4 Other Assessments

3.12.4.1 MiniCEX (for ACRRM registrars only)

A minimum of nine (9) patient consults must be reviewed using the ACRRM MiniCEX form.

The nine consults must include a:

Minimum of five (5) physical examinations, each from a different body system.

Detailed history taking of at least one (1) new patient or detailed updating patient database information on a returning patient (of at least medium complexity).

Reasonable range of types of consults, age groups and both genders.

The nine MiniCEXs must be conducted by a minimum of three (3) different reviewers.

For further criteria around these visits please visit the ACRRM website.

3.12.4.2 DISQ written reflection and Colleague Evaluation Feedback Tool

Written reflection on the results of the DISQ survey is mandated for ACRRM registrars and strongly recommended for RACGP registrars- a form is included with results from CFEP. ACRRM registrars will also undertake the Colleague Evaluation Feedback Tool (CFET) at the same time in order to complete requirements for ACRRM summative multi source feedback

3.12.5 Exams

Eligibility to sit the appropriate College exams is not an automatic process. Each College has specific requirements about time and core content completion that must be undertaken prior to enrolling for the exams. The information about these requirements can be found on the respective College websites.

Please discuss with your Training Advisor and your supervisor your readiness to sit exams. Refer also to Readiness to undertake an examination (RACGP).

Registrars will be expected to sit in the GPT3 / 4 year or PRRT3/4.

Please note: RPL without time credit will not count towards the required hospital units needed to sit. Refer to the College policies for further information.

3.12.5.1 Examination Preparation

MCCC’s policy is to assist you in becoming a competent GP. MCCC will provide exam preparation for written and clinical exams (for both RACGP and ACRRM). ACRRM and RACGP also run exam preparation workshops. Please see their respective websites

Details of what you need to do to enrol in the examinations and the dates when they will be held can be found on the examination pages of the colleges’ websites, see the following links.

RACGP Exams

ACRRM Exams


Page 46 of 70

http://www.acrrm.org.au/training-towards-fellowship/reporting-and-assessments/dates-and-enrolment

http://www.racgp.org.au/education/fellowship/exams

http://www.racgp.org.au/download/Documents/Policies/Assessment/2015/Readiness-to-undertake-an-examination-guidance-document.pdf

3.13Training time capIt is expected that all registrars training on the AGPT Programme will achieve fellowship within:

Four years from the commencement of training for full time registrars (RACGP).

Five years from the commencement of training for full time registrars (ACRRM, dual Fellowship or FARGP).

Please refer to the AGPT Training Obligations Policy for part time limits.

3.14Extension of training timeThe GP Registrar has a limited number of extensions available to them under the program.

They consist of:

Twelve (12) weeks’ extension for administration purposes (exams passed and paperwork lodged).

Six (6) months’ extension to undertake exams.

Six (6) months’ extension for additional/related training (over and above the set program).

Please ensure you read the AGPT Extension of Training Time Policy, as not all options are available in all instances.

MCCC can only provide registrars extra training assistance during approved training time.

3.15Fellowship

Both colleges have a policy or handbook, available in Appendix A, to guide you through the fellowship process.

MCCC will be in contact when you are eligible to fellow to go through these requirements. Please ensure all educational requirements have been met.

Fellowship is awarded not only on completion of College requirements but also those of MCCC.

RACGP: Vocational Training Pathway – Requirements for Fellowship Policy

ACRRM: Fellowship Training Handbook

ACRRM: Fellowship Assessment Handbook

For registrars undertaking dual fellowship with both RACGP and ACRRM, there is no requirement for registrars to wait to fellow from the RACGP while continuing towards their ACRRM fellowship. However, RACGP fellows should not submit their application to Medicare for certification of their Vocational Registration as a General Practitioner until they have attained ACRRM fellowship as well.

3.16"Z:\Training Ops\Handbooks & Resources\3. Current Version\MCCC Registrar Handbook V4.0. 21.04.2017. docx"

Page 47 of 70

http://www.acrrm.org.au/docs/default-source/documents/training-towards-fellowship/handbook-fellowship-assessment.pdf?sfvrsn=6


http://www.racgp.org.au/download/Documents/Policies/Assessment/2015/VTP-Requirements-for-Fellowship-Policy.pdf

Subsidies and grants

3.16.1 Registrar Subsidies

MCCC provides its registrars with a number of subsidies that are designed to assist them to meet their responsibilities and to complete their educational requirements in achieving professional recognition. Details of the current registrar subsidies paid by MCCC are available in the Registrar Agreement.

3.16.1.1 Accountability of MCCC and of Registrars

MCCC and its registrars have a responsibility to ensure that funds provided by the taxpayer are used responsibly and appropriately. To this end, MCCC has developed an approach to providing financial and other support to our registrars based on the principles that:

Any subsidies provided should be consistent with and reinforce policies designed to encourage registrars to live and train in our region and to seek employment in the region after completion of training.

Within these policies, payment of subsidies should be as equitable as possible to registrars wherever they might be living or be placed within the region.

The payment of subsidies should require a minimum of administrative processes.

Subsidies should only be paid for expenses incurred as a direct result of the registrar’s participation in the AGPT Program.

Where expenditure can be incurred at the discretion of the registrar, MCCC may require a contribution from the registrar.

3.16.2 Rural Procedural Grants Program

Both RACGP and ACRRM have been contracted by the Department of Health and Ageing to administer the Rural Procedural Grants Program (RPGP). It provides funding to assist GP proceduralists in rural and remote areas to maintain and upgrade their skills. More information about the program can be found at the links below.

Rural Procedural Grants Program (RPGP) RACGP

Rural Procedural Grants Program (RPGP) ACRRM

3.17Overseas Trained Doctors (OTDs)More information about the section 19AB exemption and the 10-year moratorium can be found at the link below.

Fact Sheet - Section 19AB of the Health Insurance Act

3.18"Z:\Training Ops\Handbooks & Resources\3. Current Version\MCCC Registrar Handbook V4.0. 21.04.2017. docx"

Page 48 of 70

http://www.doctorconnect.gov.au/internet/otd/publishing.nsf/Content/section19AB

http://www.acrrm.org.au/continuing-development/assistance-and-grants/rpgp

http://www.racgp.org.au/education/rural-programs/training-grants/rural-procedural-grants-program-(rpgp)/

Complaint procedureWhere a complaint or grievance arises and cannot be resolved informally, the TR0001 Complaint and Appeals Procedures should be followed. Available on MCCC website policy section.

The Complaint Reporting Form should be used and is available for completion and sent in by email.


Page 49 of 70

http://www.mccc.com.au/mymccc/forms/

4 Appendices4.1 Appendix A: Policies and forms

4.1.1 AGPT policies and forms

4.1.1.1 Program Policies

AGPT Program Policies 2017 - Overarching Document

AGPT Academic Post Policy 2017

AGPT Appeals Policy 2017

AGPT Complaints Policy 2017

AGPT Extension of Training Time Policy 2017

AGPT Program Leave Policy 2017

AGPT Remediation Policy 2017

AGPT Salary Support Policy 2017

AGPT Training Accessibility Policy 2017

AGPT Training Obligations Policy 2017

AGPT Training Region Policy 2017

AGPT Transfer Policy 2017

AGPT Withdrawal Policy 2017

4.1.1.2 Forms

Appeal Application

Deferral of Training Application

Exception to Training Obligations Application

Further Extension to Training Time Application

Notification of Withdrawal

Pathway Transfer Application

Program Leave Application

Remediation Application

Registrar Complaints Application

Subscription Application

Transfer between RTO or Training Region Application


Page 50 of 70

http://www.agpt.com.au/ArticleDocuments/233/2017%20AGPT%20Application%20-%20Transfer%20Between%20RTO%20or%20Training%20Region.pdf.aspx

http://www.agpt.com.au/ArticleDocuments/233/2017%20AGPT%20Application%20-%20Subscription.pdf.aspx

http://www.agpt.com.au/ArticleDocuments/233/2017%20AGPT%20Application%20-%20Registrar%20Complaints.pdf.aspx

http://www.agpt.com.au/ArticleDocuments/233/2017%20AGPT%20Application%20-%20Remediation.pdf.aspx

http://www.agpt.com.au/ArticleDocuments/233/2017%20AGPT%20Application%20-%20Program%20Leave.pdf.aspx

http://www.agpt.com.au/ArticleDocuments/233/2017%20AGPT%20Application%20-%20Pathway%20Transfer.pdf.aspx

http://www.agpt.com.au/ArticleDocuments/233/2017%20AGPT%20Application%20-%20Notification%20of%20Withdrawal.pdf.aspx

http://www.agpt.com.au/ArticleDocuments/233/2017%20AGPT%20Application%20-%20Further%20Extension%20of%20Training%20Time.pdf.aspx

http://www.agpt.com.au/ArticleDocuments/233/2017%20AGPT%20Application%20-%20Exception%20to%20Training%20Obligations.pdf.aspx

http://www.agpt.com.au/ArticleDocuments/233/2017%20AGPT%20Application%20-%20Deferral%20of%20Training.pdf.aspx

http://www.agpt.com.au/ArticleDocuments/233/2017%20AGPT%20Application%20-%20Appeal.pdf.aspx

http://www.agpt.com.au/ArticleDocuments/233/AGPT%20Withdrawal%20Policy%202017.pdf.aspx

http://www.agpt.com.au/ArticleDocuments/233/AGPT%20Transfer%20Policy%202017.pdf.aspx

http://www.agpt.com.au/ArticleDocuments/233/AGPT%20Training%20Region%20Policy%202017.pdf.aspx

http://www.agpt.com.au/ArticleDocuments/233/AGPT%20Training%20Obligations%20Policy%202017.pdf.aspx

http://www.agpt.com.au/ArticleDocuments/233/AGPT%20Training%20Accessibility%20Policy%202017.pdf.aspx

http://www.agpt.com.au/ArticleDocuments/233/19122016%20-%20Final%20Salary%20Support%20Program%20Policy%20-%201%20September%202016.PDF.aspx

http://www.agpt.com.au/ArticleDocuments/233/AGPT%20Remediation%20Policy%202017.pdf.aspx

http://www.agpt.com.au/ArticleDocuments/233/AGPT%20Program%20Leave%20Policy%202017.pdf.aspx

http://www.agpt.com.au/ArticleDocuments/233/AGPT%20Extension%20of%20Training%20Time%20Policy%202017.pdf.aspx

http://www.agpt.com.au/ArticleDocuments/233/AGPT%20Complaints%20Policy%202017.pdf.aspx

http://www.agpt.com.au/ArticleDocuments/233/AGPT%20Appeals%20Policy%202017.pdf.aspx

http://www.agpt.com.au/ArticleDocuments/233/AGPT%20Academic%20Post%20Policy%202017.pdf.aspx

http://www.agpt.com.au/ArticleDocuments/233/AGPT%20Program%20Policies%202017%20-%20Overarching%20Document.pdf.aspx

4.1.2 RACGP policies and forms

4.1.2.1 RACGP Examination policies

Fellowship Exams Candidate Handbook

Readiness to Undertake an Examination

4.1.2.2 Fellowship pathway policies

Applying for Fellowship of the RACGP via the Vocational Training Pathway

Applying for Recognition of Prior Learning Guidance Document

Assessment of General Practice Experience Policy

Paediatric Term Requirements

Recognition of Prior Learning Policy

Vocational Training Pathway – Examination Eligibility Policy

Vocational Training Pathway – Requirements for Fellowship Policy

Witnessing and Certification of Documentation Policy

4.1.2.3 Education Services exceptions policies

Educational Misconduct Policy

Education Services Appeals Policy

RACGP Examinations Special Consideration Policy

4.1.2.4 Forms

Application for Appeal

Application for Reconsideration

Application for Special Consideration


Page 51 of 70

http://www.racgp.org.au/download/Documents/Fellowship/Application-for-Special-Consideration_15-April-2015.pdf

http://www.racgp.org.au/download/Documents/Fellowship/Reconsideration-form-and-invoice.pdf

http://www.racgp.org.au/download/Documents/Fellowship/Appeal-form-and-invoice.pdf

http://www.racgp.org.au/download/Documents/Fellowship/CURRENT-Policy-RACGP-Examinations-Special-Consideration-Policy-Publi.pdf

http://www.racgp.org.au/download/Documents/Fellowship/Education-Services-Appeals-Policy.pdf

http://www.racgp.org.au/download/Documents/Policies/Assessment/Educational-Misconduct-Policy.pdf

http://www.racgp.org.au/download/documents/Policies/Assessment/witnessing_and_certification_policy.pdf

http://www.racgp.org.au/download/Documents/Policies/Assessment/2015/VTP-Requirements-for-Fellowship-Policy.pdf

http://www.racgp.org.au/download/Documents/Policies/Assessment/2015/VTP-Examination-Eligibility-Policy.pdf

http://www.racgp.org.au/download/Documents/Policies/Assessment/policy-recognition-of-prior-learning.pdf

http://www.racgp.org.au/download/Documents/Policies/Assessment/2015/Paediatric-Term-Requirements-Guidance-Document.pdf

http://www.racgp.org.au/download/Documents/Policies/Assessment/assessment-of-general-practice-experience.pdf

http://www.racgp.org.au/download/Documents/Policies/Assessment/2015/Applying-for-Recognition-of-Prior-Learning-Guidance-Document.pdf

http://www.racgp.org.au/download/Documents/Policies/Assessment/2015/Applying-for-Fellowship-of-the-RACGP-via-the-VTP-Guidance-Document.pdf

http://www.racgp.org.au/download/Documents/Policies/Assessment/2015/Readiness-to-undertake-an-examination-guidance-document.pdf

http://www.racgp.org.au/download/Documents/Policies/Assessment/fellowship-exams-candidate-handbook.pdf


Page 52 of 70

4.1.3 ACRRM policies

Fellowship Training Handbook (contains most ACRRM training policies)

Appeals Policy

Completion of Training Policy

Fellowship Assessment Handbook

Grievance Policy

Refund policy

Registrar Review Policy

Special Consideration for Assessment Policy

4.1.4 MCCC policies, forms and documents

4.1.4.1 Education policies

ED 0001 Education and Training Philosophy

ED 0002 Recognition of Prior Learning for ACRRM Registrars Policy and Procedure

ED 0003 Recognition of Prior Learning for RACGP Registrars Policy and Procedure

ED 0004 Extended Skills Post Application Procedure

ED 0005 Registrar in Difficulty Procedure

ED 0006 Practice Readiness Policy and Procedure

ED 0007 Accreditation of Training Posts and Supervisors Policy

ED 0008 Registrar Wellbeing Policy

ED 0009 Extension of Training Policy and Procedure – under review

ED 0010 Accreditation of ARST and AST Posts Procedure

ED 0012 Out-of-Practice Education Attendance Policy

ED 0014 Accreditation of Training Posts Using Blended Supervision Models Procedure – under review

ED 0015 Therapeutic Relationships Policy

ED 0016 Practice and Supervisor Monitoring and Support Procedure

ED 0017 Withdrawal of College Accreditation Procedure

ED 0018 Management of Registrar Learning Needs and Learning Plan Policy

ED 0019 Orientation of Registrars in Training Posts Policy

ED 0022 Training Post Supervisor Accreditation Procedures – New Post


Page 53 of 70

http://www.mccc.com.au/wp-content/uploads/2015/12/ED-0022-Training-Post-Supervisor-Accreditation-Procedures-New-Post-v2.0-13.06.2017.docx

http://www.mccc.com.au/wp-content/uploads/2017/02/ED0018-Management-of-Registrar-Learning-Needs-and-Learning-Plan-Policy-v1.0.pdf

http://www.mccc.com.au/wp-content/uploads/2017/02/ED0018-Management-of-Registrar-Learning-Needs-and-Learning-Plan-Policy-v1.0.pdf

http://www.mccc.com.au/wp-content/uploads/2015/12/ED-0017-Withdrawal-of-College-Accreditation-Procedure-v1.0.pdf

http://www.mccc.com.au/wp-content/uploads/2015/12/ED-0016-Practice-and-Supervisor-Monitoring-and-Support-Procedures-v1.0.pdf

http://www.mccc.com.au/wp-content/uploads/2015/12/ED-0015-Therapeutic-Relationships-Policy-v1.0.pdf


http://www.mccc.com.au/wp-content/uploads/2015/12/ED-0010-Accreditation-of-ARST-and-AST-Posts-Procedure-v2.0.pdf

http://www.mccc.com.au/wp-content/uploads/2015/12/ED0008-Registrar-Wellbeing-Policy-and-Procedure-v2.0.pdf

http://www.mccc.com.au/wp-content/uploads/2017/01/ED-0007-Accreditation-of-Training-Posts-and-Supervisors-Policy-v1.0.pdf

http://www.mccc.com.au/wp-content/uploads/2017/01/ED-0006-Practice-Readiness-Policy-and-Procedure-v1.0.pdf

http://www.mccc.com.au/wp-content/uploads/2017/01/ED-0005-Registrar-in-Difficulty-Procedure-v1.0.pdf

http://www.mccc.com.au/wp-content/uploads/2015/12/ED-0004-Extended-Skills-Post-Application-Procedure-v2.0.pdf

http://www.mccc.com.au/wp-content/uploads/2015/12/ED-0003-Recognition-of-Prior-Learning-for-RACGP-Registrars-Policy-and-Procedure-v1.0.pdf

http://www.mccc.com.au/wp-content/uploads/2015/12/ED-0002-Recognition-of-Prior-Learning-for-ACRRM-Registrars-Policy-and-Procedure-v3.0-1.pdf

http://www.mccc.com.au/wp-content/uploads/2015/12/ED-0001-Education-and-Training-Philosophy-v2.0.pdf

http://www.acrrm.org.au/docs/default-source/documents/training-towards-fellowship/special-considerations-policy.pdf?sfvrsn=2

http://www.acrrm.org.au/docs/default-source/documents/training-towards-fellowship/registrar-review-policy-july-2012.pdf?sfvrsn=0

http://www.acrrm.org.au/docs/default-source/documents/the-college-at-work/policy-document---refunds20140707.pdf?sfvrsn=0

http://www.acrrm.org.au/docs/default-source/documents/training-towards-fellowship/grievance-policy-august-2012.pdf?sfvrsn=0

http://www.acrrm.org.au/docs/default-source/documents/training-towards-fellowship/handbook-fellowship-assessment.pdf?sfvrsn=6

http://www.acrrm.org.au/docs/default-source/documents/training-towards-fellowship/completion-of-training-policy-january-2014.pdf?sfvrsn=0

http://www.acrrm.org.au/docs/default-source/documents/training-towards-fellowship/appealspolicy.pdf?sfvrsn=2


ED 0028 Adverse event critical incident serious issue and near miss procedure

4.1.4.2 Training policies

TR 0001 Complaint and Appeals Procedure

TR 0002 Diversity of Training Experience Policy and Procedure

TR 0003 Training Obligations Policy

TR 0004 Transfer in to MCCC Policy

TR 0005 Transfer Out of MCCC Procedure

TR 0006 Transfer between Training Pathways Procedure

TR 0007 Practice Matching Policy and Procedure

TR 0008 Medicare Provider Number Procedure – under review

TR 0009 Registrar Selection Procedure

TR 0010 Educational Funding for Registrars Procedure

TR 0011 Funding for New Practices

TR 0012 Metro West Outer Metro Training Requirements and Restriction Policy

TR 0013 Change of MCCC Region Policy

TR 0014 Leave from AGPT Program Procedure

TR 0015 Withdrawal Policy

TR 0016 Training Practice Funding Policy

TR 0017 Extension of Training Time – under review

TR 0019 Operational Procedure for pre-existing relationships and the employment and training of GP Registrars at MCCC

4.1.4.3 ACRRM MiniCEX Supervisor Pack

Formative MiniCEX scoring form– Australian College of Rural & Remote Medicine

MiniCEX conducted by Supervisor – Guidance document – MCCC GP Training

Physical exam reference – Australian College of Rural & Remote Medicine

4.1.4.4 Assessment

Supervisor Report – available via Pivotal

4.1.4.5 Training

Application to change region

Application for Leave from AGPT


Page 54 of 70

http://www.mccc.com.au/wp-content/uploads/2016/05/MCCC-Application-for-Leave-from-AGPT-v1.2-02.05.2016.pdf

http://www.mccc.com.au/wp-content/uploads/2016/11/MCCC-Application-to-Change-Region-v3.0-15.11.2016.doc

http://www.mccc.com.au/wp-content/uploads/2015/12/physical-exam-reference-1.pdf

http://www.mccc.com.au/wp-content/uploads/2015/12/MiniCEX-conducted-by-Supervisor-Guidance-Document-1.docx

http://www.mccc.com.au/wp-content/uploads/2015/12/formative-minicex-scoring-form-3.pdf

http://www.mccc.com.au/wp-content/uploads/2015/12/TR0019-Operational-Procedure-for-pre-existing-relationships-and-registr....pdf

http://www.mccc.com.au/wp-content/uploads/2015/12/TR0019-Operational-Procedure-for-pre-existing-relationships-and-registr....pdf

http://www.mccc.com.au/wp-content/uploads/2017/01/TR-0016-Training-Practice-Funding-Policy-v1.0.pdf

http://www.mccc.com.au/wp-content/uploads/2017/01/TR-0015-Registrar-Withdrawal-Policy-and-Procedure-v1.0.pdf

http://www.mccc.com.au/wp-content/uploads/2015/12/TR-0014-Leave-from-AGPT-Program-Procedure-v2.0.pdf

http://www.mccc.com.au/wp-content/uploads/2017/01/TR-0013-Change-of-MCCC-Region-Policy-v1.0.pdf

http://www.mccc.com.au/wp-content/uploads/2017/01/TR-0012-Metro-West-Outer-Metro-Training-Requirements-and-Restriction-Policy-v1.0.pdf

http://www.mccc.com.au/wp-content/uploads/2017/01/TR-0011-Education-Funding-for-New-Practices-Policy-v1.0.pdf

http://www.mccc.com.au/wp-content/uploads/2017/01/TR-0010-Educational-Funding-for-GP-Registrars-Procedure-v1.0.pdf

http://www.mccc.com.au/wp-content/uploads/2017/01/TR-0009-Registrar-Selection-Procedure-v1.0.pdf

http://www.mccc.com.au/wp-content/uploads/2017/01/TR-0007-Practice-Match-Policy-and-Procedure-v2.0.pdf

http://www.mccc.com.au/wp-content/uploads/2015/12/TR-0006-Transfer-Between-Training-Pathways-Procedure-v2.0.pdf

http://www.mccc.com.au/wp-content/uploads/2015/12/TR-0005-Transfer-out-of-MCCC-Procedure-v2.0.pdf

http://www.mccc.com.au/wp-content/uploads/2015/12/TR-0004-Transfer-in-to-MCCC-Procedure-v2.0-1.pdf

http://www.mccc.com.au/wp-content/uploads/2017/01/TR-0003-Training-Obligations-Policy-v1.0.pdf

http://www.mccc.com.au/wp-content/uploads/2015/12/TR-0002-Diversity-of-Training-Experience-Policy-v2.0.pdf

http://www.mccc.com.au/wp-content/uploads/2015/12/TR-0001-Complaint-and-Appeals-Procedure-v3.0.pdf

http://www.mccc.com.au/wp-content/uploads/2015/12/ED0028-Adverse-event-critical-incident-serious-issue-and-near-miss-procedure-v2.0.pdf

Application to Undertake an Extended Skills Post

Diversity of Training Experience Variation Procedure

Variation to RACGP Training Diversity Application

Variation of Training Time Application

4.1.4.6 External Clinical Training Visits

ACRRM MiniCEX Scoring Form

ECTV Feedback Form – available via Pivotal

ECTV Patient Consent

ECTV Supervisor Claim Form

Verbal Consent Form for Video Recording a Consultation

Video Recording Consent Form

4.1.4.7 Training Advisor Visits

MCCC Supervisor Claim Form – TA Visits

4.1.4.8 Feedback

Registrar Feedback Form for Registrars to provide feedback on the practice they work in. This form is available on Pivotal.

Supervisor Feedback Form for Supervisors to provide feedback on the Registrar/s they supervise in their practice. This form is also available on Pivotal.

4.1.4.9 Orientation

MCCC Orientation Checklist

4.1.4.10 Registrar claims for reimbursement

Registrar Claim for Relocation Reimbursement

Registrar Claim for Expense Reimbursement

4.1.4.11 Reviewing the progress of GP Registrars

Training Advisor Review Meeting – available via Pivotal

4.1.4.12 Complaints

MCCC Complaint Form

4.1.5 National Terms and Condition for the Employment of Registrars


Page 55 of 70

http://www.mccc.com.au/wp-content/uploads/2015/12/MCCC-Complaint-Form-v1-0-08-02-2016.doc

http://www.mccc.com.au/wp-content/uploads/2016/08/Form-Educational-Funding-for-GP-Registrars-Application.doc

http://www.mccc.com.au/wp-content/uploads/2015/12/REGISTRAR-Claim-for-Relocation-Reimbursement.pdf

http://www.mccc.com.au/wp-content/uploads/2016/01/MCCC-Orientation-Checklist-v1.1-27.01.2016.doc

http://www.mccc.com.au/wp-content/uploads/2016/08/MCCC-Supervisor-Claim-Form-TA-Visits.doc

http://www.mccc.com.au/wp-content/uploads/2016/09/Video-Recording-Consent-Form-v1.0-02.08.2016.pdf

http://www.mccc.com.au/wp-content/uploads/2016/09/Verbal-Consent-Form-for-Video-Recording-a-Consultation-v1.0-02.08.2016.pdf

http://www.mccc.com.au/wp-content/uploads/2016/08/MCCC-Supervisor-Claim-Form-ECTV.doc

http://www.mccc.com.au/wp-content/uploads/2015/12/ECTV-Patient-Consent.docx

http://www.mccc.com.au/wp-content/uploads/2015/12/formative-minicex-scoring-form-Nov2015-ACRRM.docx

http://www.mccc.com.au/wp-content/uploads/2016/09/MCCC-Variation-of-Training-Time-Application-v1.0-02.08.2016.doc

http://www.mccc.com.au/wp-content/uploads/2016/11/MCCC-Variation-to-RACGP-Training-Diversity-Application-Form-v2.0-15.11.2016.doc

http://www.mccc.com.au/wp-content/uploads/2016/07/MCCC-1-4-Diversity-of-Training-Experience-Variation-Procedure-v1.1-19-07-2016.doc

http://www.mccc.com.au/wp-content/uploads/2016/05/Application-to-Undertake-an-Extended-Skills-Post-2016....pdf

National Terms and Conditions for the Employment of Registrars (NTCER)


Page 56 of 70

https://www.google.com.au/url?sa=t&rct=j&q=&esrc=s&source=web&cd=1&cad=rja&uact=8&ved=0ahUKEwiL5NfByLTRAhWCJpQKHYpPBGIQFggbMAA&url=https%3A%2F%2Fgpra.org.au%2Fnational-terms-and-conditions-for-the-employment-of-registrars%2F&usg=AFQjCNGMHweLV5PbxocEvNDlxHKDOT6zbA&sig2=BNuGJ9Y_er7j06nKDFiK4Q

4.2 Appendix B: OrientationThorough orientation of the registrar to the practice is essential. This is usually provided by the practice manager, practice nurse and supervisor (in most practices, a combination of the three).

The Orientation Checklist is available on the MCCC website, under MyMCCC, forms.

For GPT1 registrars

For GPT1 registrars, the orientation process might occur over a series of days rather than all at once. To qualify for the Registrar Orientation Payment the following orientation must be competed and co-signed by the registrar. It can be submitted with the GPT1 initial in-practice performance assessment form.

For GPT1 registrars, it is suggested that at least the first day in general practice be spent in orientation, sitting in with supervisor consultations, and the first formal teaching session. The registrar is likely to need some time with the practice manager as well, to ensure all paperwork is complete (e.g. provider number, prescriber number and insurance). Depending on the registrar’s experience, a plan for when they will see their first patients and the timing of bookings can be made.

Orientation to the Medical Practice

The Registrar’s role – reinforcing their role as an independent practitioner, with appropriate consultation with the supervisor.

Professional Behaviour:

Terms of address – patients/staff

Privacy and confidentiality

Punctuality

Dress code

Mobile phone/social media use and practice policy

Overview of terms and conditions – working hours, remuneration, overtime

Procedure for altering work hours, sick leave, annual leave

Who to approach with questions/concerns (non-medical)

Practice Meetings – Doctors, Staff, CME

Who works in the practice/practice management:

Welcome and introduction to staff including a list of staff names and

positions

Who is responsible for what?

Practice Nurse: Procedures undertaken by nurse/immunizations

Tour of premises/Surgery hours:

Where are medical supplies and stationery?

Parking and access to the building in and after hours

Tea room, where to leave bag, lunch arrangements

Information regarding local area e.g. banks, shops, food outlets

In-Practice Teaching/Learning Plan/Release Days:

MCCC workshop dates – when, booked in

Discussion about ECTVs

Arrangements for tutorials – when, where, who with

Plan for learning

When/who to ask for assistance:

Process for ‘corridor’ consultations, e.g. phone advice, calling-in, messaging systems, second opinions,


Page 57 of 70

http://www.mccc.com.au/wp-content/uploads/2016/01/MCCC-Orientation-Checklist-v1.1-27.01.2016.doc

who can be approached, how and when?

Arrangements for support in and out of hours

Arrangements for threatening/unsafe situations

Equipment in Surgery/Doctors Bag:

Practice resources/practice library

Therapeutic Guidelines and use where available

Other – e.g. internet, shared passwords to electronic online/offline resources

Patient information resources

Telephone System:

Use of lines, on-hold, transferring calls

Communications between staff and doctors

Policy for returning calls to patients

Reception Area/Office Equipment:

In-tray/pigeon hole

Document shredding/recycling

Photocopier, fax, scanner

Prescription box

Front office use – appointments, accounts etc.

Computer System:

Password, turning on, logging on, turning off

Consulting Room:

Phone system – extensions, emergency calls

Equipment – otoscope/ophthalmoscope, urine testing, sphygmomanometer

Pathology supplies – pap kits, swabs, urine pots

Waste – paper recycling, medical waste, sharps, laundry

Duress alarms, how they work and who is alerted when activated

Practice Policy and Procedure Manual:

Particular areas of importance to new doctor. E.g. Infection Control, sterilization procedures, occupational health and safety, normal & abnormal results, threats, evacuations.

Specific Practice Policies:

Billing policy

Protocol for dealing with the aggressive or violent patient

S8 drugs/drugs of addiction

Repeat prescriptions

Telephone calls including results

Grievance/complaints policy

Patients without appointments

Injuries including needle stick

Orientation to general practice systems

Emergencies:

Ambulance

Resuscitation procedures

Emergency retrievals and advice

Poisons information

Appointment System:

Practice policy regarding appointments

Medical Records:

Filing system and accessing records

Computerized records

Preferred method of record keeping

Results – protocol for checking and filing

Billing Procedures:

Common list of fees and item


Page 58 of 70

numbers

Practice policy on private and bulk billing

Commonly used procedures

Various medicals, vaccines and dressings

Medicare guidelines for rebates

When and how to privately bill after hours

Communicating billing to front office

The use of EPC items

Pharmaceutical Benefits Scheme – PBS, Authority Scripts, Private, OTC

Workers Compensation/TAC

Pathology – Sample collection, preferred provider, blood pressure monitoring

Radiology Services – X-ray services, ultrasounds, bone density

After Hours:

Roster

How to open and lock-up the surgery/security system code

Accessing medical records

Weekend surgeries

Billing after hours

Home Visits

Hospital(s) and Hospital admissions (include accessing VMO rights, specific details on orientation to local rural hospital)

Nursing Home(s) and Aged Care:

Aged Care Assessment Team

Respite care

Enhanced Primary Care Medicare Items

Day Centre

Referrals

Specialists

Community Nursing Service

Palliative Care

Diabetes Services:

Diabetes Educator

Dietician

Podiatrist

Diabetes Australia

National Diabetes Supply Scheme

Purchase of Blood Glucose Monitors

Dentists

Mental Health Services – Alcohol and Drug Rehabilitation

Cardiology Services

Other Allied Health Professionals:

Audiology

Counselling

Occupational Therapy

Optometrists

Physiotherapists

Podiatrists

Psychologists

Social Workers

Fertility Clinics

Shared Care – Antenatal/Diabetes

Termination of Pregnancy – Surgical/Medical

Other

Child abuse – Mandatory Reporting

Medical Examinations: Non-Medicare, pre-employment, insurance, diving, commercial Vehicle License

Medico-Legal Reports

Sexual Assault

Funeral Services

Orientation to the Local Community


Page 59 of 70

Accommodation (if required)

Orientation to Local Hospital and/or Nursing Home if appropriate

Demographics of patients and community

Social activities in the community

Local Primary Health Network (PHN)

Other local sources of GP medical education

Local Services:

Pharmacies

Schools

Places of worship – churches, temples, mosques, etc.

Community Centre

Library

Community Service Groups

Orientation was provided to the registrar and the relevant items above were discussed:

Supervisor Name:

Signed: Date:

Registrar Name:

Signed: Date:


Page 60 of 70

4.3 Appendix C: Registrar competency benchmarking1. Introduction

1.1 Purpose

The following document serves as a synopsis of the Colleges’ (RACGP and ACRRM) standards required of general practice registrars as they progress through training towards Fellowship. It has been designed to contract the extensive number of required competencies cited in College documents in to statements that are more readily useable in the medical education arena.

This work provides medical educators a meaningful and user-friendly summary of required competencies that can be used when both designing assessments and when assessing registrar performance.

The document assumes that a registrar at a more advanced level of training will have obtained the skills described at the preceding level.

It is expected that a user requiring greater depth of information about a particular competency or domain will use the links provided to refer to the Colleges’ parent documents.

For a visual summary of these competencies, please see the Core Competencies Spreadsheet.

1.2 Audience

The target audience for this synopsis is medical educators involved in the assessment of registrar competency.

1.3 Definitions

Entry to GPT1/PRRT1: The number of hospital years a GPT1/PRRT1 registrar will have experienced varies greatly, though the minimum number is two.

In commencing GPT1/PRRT1, registrars should recognise the difference between general practice and other specialties, particularly the GP as the gatekeeper and coordinator of care, and the community context of general practice. The registrar will then begin to apply and develop the skills of general practice: the nature of general practice presentations, continuity of care, undifferentiated illness, and the systems of practice. By the end of GPT1/PRRT1, registrars will be “just settled in”.

General practice under supervision: end GPT1-GPT2 and end PRRT1-PRRT2: During GPT2/PRRT2, registrars are comfortable with and use a wide range of general practice skills. They become less reliant on their supervisor and work more independently and collaboratively. By the end of GPT2/PRRT2 the majority of registrars will be ready to sit the College exam. Others may need additional support to hone knowledge and skills. Exam preparedness does not equate to readiness for vocational registration and unsupervised practice. By the end of GPT2/PRRT2, registrars are well settled in to general practice.

At time of fellowship: GPT3-GPT4/ PRRT3-PRRT4: A registrar at time of Fellowship is exam-ready and has demonstrated enhanced knowledge. They are proficient in their skills and capable of working independently and collaboratively.


Page 61 of 70

2. Competency Benchmarks2.1 Entry to GPT 1/PRRT1

Communication skills (Doctor/patient and doctor/inter-professional)

Has effective communication skills and uses language that is easy to understand; is warm and sympathetic, establishes rapport and listens and responds to verbal cues.

Communicates effectively in written word (clinical notes and referral letters.

Identifies and manages patients who are angry, distressed; has a framework for appropriately breaking bad news.Identifies patients whose care may be enhanced or undermined by involvement of family members; can manage confidentiality and informed consent.

Recognises patients who benefit from health promotion, self-care and counselling and appreciates barriers to implementing these strategies.

Identifies culturally appropriate communication with both Aboriginal and Torres Strait Islander peoples and those from culturally diverse backgrounds and the role of Aboriginal and Torres Strait Islander cultural educators and mentors; appreciates impact cultural beliefs, behaviours and intergenerational trauma have on Aboriginal and Torres Strait Islander peoples’ health.

Providing medical care

History Takes a history of the presenting complaint with an appropriate review of systems, using a biopsychosocial model.

Identifies the ideas, concerns and expectations of the patient and describes strategies to manage unrealistic patient or carer expectations.

Recognises the impact sociocultural factors have on presentations, compliance and patient engagement.

Physical Examination

Conducts an appropriate and focused examination with consent.

Investigations Identifies patients in whom investigations are required to make a diagnosis or create a management plan, outlining the factors to consider when choosing the most appropriate investigation.

Effectively communicates results to the patient.

Diagnosis Identifies and manages the acutely unwell patient.

Synthesises clinical information to create an appropriate list of differential diagnoses; can discriminate between the possible differential diagnoses relevant to the presenting complaint.

Management(Including response to

Takes appropriate steps to manage serious illness; manages acute emergencies: asthma, anaphylaxis, seizures, chest pain/AMI, shock, poisoning, overdose, envenomation, haemorrhage.


Page 62 of 70

medical emergencies)

Identifies evidence-based guidelines and key factors to consider when prescribing medication; can communicate evidence and medication management plan to patients.

Identifies which patients will benefit from procedures; can obtain informed consent and determine which procedures can be safely done in general practice and those that require referral.

Appreciates the risk associated with managing patients with undifferentiated illness.

Understands the role of general practice in coordinating patient care to minimize fragmentation; identifies the role of the multidisciplinary team in patient care and makes timely, appropriate referrals.

Procedural SkillsIs able to do: CPR, ECG, IM injections, suture lacerations. (See also: Skills and Procedures ) .

Cognitive Skills Synthesises information and problem solves at level of simple complexity; uses hypothetical-deductive method for problem solving.

Demonstrates a willingness to learn and improve; is reflective and self-aware.

Can adapt to different work and clinical situations.

Addressing health needs of Aboriginal and Torres Strait Islander, other culturally diverse groups and disadvantaged communities

Describes conditions and health risks prevalent in Aboriginal and Torres Strait Islander and other culturally diverse populations and barriers to delivering care; identifies local resources that assist in addressing these communities’ needs

Population Health & the Context of General Practice

Has a patient-centred approach; considers the psychosocial and cultural determinants of health and recognises vulnerable groups in the community.

Understands public health roles relevant to general practice and public health risks addressed in general practice.

Describes the MBS and PBS systems.

Begins engaging with the community.

Describes differences in morbidity and mortality in Aboriginal and Torres Strait Islander populations and the doctor’s role in promoting health equality in all culturally diverse and disadvantaged populations.

Professional, Intellectual & Ethical RoleBehaves professionally at all times; respect, duty of care, boundaries, confidentiality, safety and privacy principles are understood and practised.Is committed to general practice; understand the principles of self-care and advocacy for patients.Is willing to learn and extend; identifies learning needs and takes responsibility for learning, identifies and commits to quality improvement strategies.


Page 63 of 70

http://curriculum.cpmec.org.au/skillsprocedures.cfm


Describes the role research plays in reducing health inequality in Aboriginal and Torres Strait Islander populations and other culturally diverse groups. Reflects on own assumptions, cultural beliefs and emotional reactions in providing culturally safe care.

Organisational, & Legal Dimensions

Maintains appropriate medical records; identifying what information must be recorded, principles of record storage and legalities of use of patient data.Understands legal requirements; reportable deaths, medico-legal report writing, confidentiality and informed consent.May have difficulty with time management but is organised and has a good work ethic.Identifies models of care and policies relevant to Aboriginal and Torres Strait Islander health as well as other culturally diverse groups.

Practicing medicine in the rural & remote contextParticipates in the provision of care away from other medical services; respects local community values; commits to the acquisition of knowledge required to care for the local population.

Provides care in the hospital setting

Participates in the admission of patients to hospital; applies relevant protocols; communicates with healthcare personnel and provides appropriate handovers.

Response to medical emergencies

Arranges evacuation; communicates with receiving clinical personnel; performs an initial assessment of the critically ill patient.

Useful Links1. Australian curriculum framework for junior doctors 2. RACGP Curriculum for Australian General Practice 2016: Core skills unit 3. RACGP Curriculum for Australian General Practice 2016: Aboriginal and Torres Strait Islander

Health Unit4. ACRRM Primary Curriculum 4th Edition


Page 64 of 70

http://www.acrrm.org.au/PrimaryCurriculum/Default.htm

http://curriculum.racgp.org.au/statements/aboriginal-and-torres-strait-islander-health/


http://www.racgp.org.au/download/Documents/Curriculum/2016/core-skills-unit_v10.pdf

http://curriculum.cpmec.org.au/

2.2 General practice under supervision: GPT 2/PRRT2


Consolidates and refines communication skills; engenders confidence and trust, appropriately uses closed and open questions, shows sympathy and empathy and interest in patients.

Begins to manage more difficult patients; mental health problems, heart-sink patients, patient complaints, breaking bad news, carer distress and end-of-life decisions.Addresses barriers to patients implementing health promotion and prevention strategies; motivates and assists patients and recognises opportunity for health education.Identifies Aboriginal and Torres Strait Islander patients as well as those from other culturally diverse groups and addresses barriers to care and communication; communicates in a culturally safe manner; optimizes patient empowerment.


History Elicits a good history; incorporates the biopsychosocial approach and patient preferences where possible; appreciates the impact diagnoses have on the patient’s family and context.Elicits the patient agenda (ICE) and reconciles this with the doctor agenda; creates a mutually agreed problem list.


Conducts an appropriate and focused examination with consent and demonstrates correct technique and use of clinical tools.

Investigations Judiciously orders investigations and is aware of public health costs; describes the risks and benefits of investigations.

Develops recall and reminder strategies for handling results.

Diagnosis Develops a diagnosis and executes a management plan for acute serious illness and trauma.

Refines diagnostic powers; fewer diagnostic dilemmas, differential diagnoses are risk stratified; differential list is better prioritized and defended.

Management(Including response to medical emergencies)

Effectively communicates with and counsels patients about management options including use of safety net.

Uses unbiased and appropriate patient and guideline resources when prescribing, managing and referring for procedures; discussed side effects and risks with patients.

Understand principles of restricted medications and off-label prescribing, manages medication misuse and withdrawal; has a framework for managing compliance issues.

Manages diagnostic uncertainty and undifferentiated illness with greater skill; appreciates mental health conditions that confound presentations of undifferentiated illness.Effectively communicates with health professionals, provides hand-overs; implements strategies to reduce fragmentation of care


Page 65 of 70

Procedural Skills Able to do: vaccinations, blood glucose testing, cervical cytology, simple dressings.Optional skills may include: proctoscopy, cryotherapy, curettage and shave excision, punch biopsy, excision of simple skin lesions, cautery, incision and drainage of abscess, drainage of joint effusion, joint injections, insertion of hormonal implants, spirometry. See also: Skills and Procedures.

Cognitive Skills Synthesises information and problem solves at level of moderate complexity; uses pattern matching when problem solving.

Conducts a structured consultation and competently manages common presentations.

Addressing health needs of Aboriginal and Torres Strait Islander, other culturally diverse groups and disadvantaged communities

Manages diagnostic uncertainty related to cultural beliefs and uses strategies & resources to enhance health outcomes.

Begins to apply principles of partnership, community ownership, consultation, capacity building, reciprocity and respect to health care delivery to disadvantaged groups.

Population Health & the Context of General Practice

Implements individual and national population based screening activities in the consultation; motivates patients to participate.

Advocates for vulnerable groups and appropriately accesses government funded programs.

Understands requirements for public health notification; can manage public health risks and communicable disease outbreaks.Uses evidence and healthcare delivery strategies (including MBS programs, health promotion & community education) to reduce health inequality in Aboriginal and Torres Strait Islander populations and other disadvantaged groups.

Professional, Intellectual & Ethical RoleBehaves professionally at all times; respect, duty of care, boundaries, confidentiality, safety and privacy principles are understood, practiced and evaluated.Is committed to general practice; practices the principles of self-care and advocacy for patients and coordinates patient care.Is willing to learn and extend; identifies learning needs and takes responsibility for learning, identifies and commits to quality improvement strategies including reporting and managing critical incidents; seeks to learn alongside others.Understands mandatory reporting and has a framework for supporting a colleague in difficulty.Describes ethical approaches to research in Aboriginal and Torres Strait Islander health and other culturally diverse groups.

Organisational, & Legal DimensionsEffectively uses practice systems (including IT systems) for patient care; reviews, recalls, handling of abnormal test results, managing failures to attend.Identifies and manages occasions when duty of care clashes with confidentiality requirements; understands when MDO advice is required.Demonstrates an understanding of patient competency and shared decision making; appreciate legalities of caring for patients who cannot give consent.


Page 66 of 70


Understands certification; WorkCover, Centrelink, care plans, billing rules, notification requirements, involuntary admission legislation.Understands Aboriginal community controlled health services; uses government programs and policies to enhance care delivery to Aboriginal and Torres Strait Islander peoples.

Practicing medicine in the rural & remote context

Provides effective clinical care when distant from medical services; demonstrates resourcefulness when working in isolation; arranges appropriate referral to distant services, is becoming confident in the use of information and communication technology in provision of care.


Develops and implements management plans for hospitalised patients including the management of fluids and blood products; monitors clinical progress; manages the deteriorating patient; arranges transfer to other facilities; engages in discharge planning.


Provides definitive emergency care, resuscitation and performs procedures across all patient ages.

Useful Links1. Australian curriculum framework for junior doctors 2. RACGP Curriculum for Australian General Practice 2016: Core skills unit 3. RACGP Curriculum for Australian General Practice 2016: Aboriginal and Torres Strait Islander



Page 67 of 70




http://www.racgp.org.au/download/Documents/Curriculum/2016/core-skills-unit_v10.pdf

http://curriculum.cpmec.org.au/

2.3 At time of fellowship: GPT3-GPT4/ PRRT3-4


Communication style is respectful, clear and adaptive; adjusts communication to suit age, gender, cultural background, emotional state and physical state of the patient.Involves the patient in decision-making; provides appropriate explanations, discusses diagnostic and management possibilities, negotiates courses of action, encourages feedback and input from patients and carers.Coordinates care that is continuous and meets the needs of patients in their context; offers advice on health options and communicates with family members and practitioners involved in the patient’s care.Uses a patient-centred, whole person approach that builds mutual confidence; understands the impact a patient’s culture, history, gender and background impacts on their experience of health; seeks to promote health and wellbeing.Aboriginal and Torres Strait Islander patients are identified. Culturally safe communication is practiced with all culturally diverse groups; historical and cultural influences are appreciated and incorporated in to the consultation. Uses interpreters, key community contacts and networks as appropriate


History Takes a comprehensive, structured and biopsychosocial history from the patient and documents this clearly; interprets symptoms in their socio-cultural and medical context.


Performs a respectful, appropriate and competently executed examination, with consent.

Investigations Rational investigations are ordered and explained; a structured framework for following results up is in place.

Diagnosis Differential diagnoses are rational and defensible; uncertainty and undifferentiated illness is managed.

Management(Including response to medical emergencies)

Manages a wide variety of patients and problems comprehensively and in a cost-effective and evidence-based manner; works within limits of own expertise and coordinates the involvement of appropriate health practitioners.

Procedural Skills May be developing an interest and proficiency in a procedural field.

Cognitive Skills Synthesises information and problem solves at level of increased complexity; draws on various resources and skills in doing so. Is critical and discriminating.Has honed reflective abilities and insight.

Addressing health needs of Aboriginal and Torres Strait Islander, other culturally diverse groups and disadvantaged

The conduct of the consultation is appropriate to the need of the Aboriginal and Torres Strait Islander person and their sociocultural context.

Works with culturally diverse and disadvantaged groups to address barriers in access to health services and improve the determinants of health.


Page 68 of 70

communitiesPopulation Health & the Context of General Practice

Promotes holistic health and preventative care to individuals and to groups, appreciating the individual, contextual and epidemiological determinants of health and disease.Advocates for patients, identifies and manages barriers to care.

Practices in a cost-conscious manner; has a deeper understanding of the Australian healthcare system.Promotes screening and management decisions based on an understanding of Aboriginal and Torres Strait Islander person health needs as well as those of other culturally diverse and disadvantaged groups.

Professional, Intellectual & Ethical RolePractices professionally and adheres to the code of professional conduct; justice, beneficence, non-maleficence, autonomy and confidentiality.Engages in self-care and maintains a balance between involvement and applying appropriate boundaries.Is committed to lifelong learning, actively and independently seeking out educational opportunities; engages in the education of others.Takes a leadership role in arenas outside of patient care (organisations, community groups, practice meetings).Identifies opportunities for research and teaching in Aboriginal and Torres Strait Islander health and other disadvantaged groups.

Organisational, & Legal DimensionsManages the systems of General Practice: (data management, documentation, certificates, insurance matters, billing, care plans and practice management).Understands and works within statutory and regulatory requirements; manages medico-legal responsibilities, recalls and reminders and confidentiality.Manages time effectively.Is aware of strategies that promote culturally safe practices; uses policies and initiatives to promote equality in care of all culturally diverse groups.

Practicing medicine in the rural & remote contextPractices independently in isolation; provides supervision to healthcare personnel; uses information and communication technology to manage patients and communicate with colleagues.


Provides supervision to healthcare personnel; manages adverse events; participates in quality improvement initiatives; contributes to the medical expertise of the hospital team.


Leads an inter-professional team in delivering emergency care; participates in disaster planning; stabilizes critically ill patients, providing both primary and secondary care; performs required emergency procedures.

Useful links:1. Competency profile of the Australian general practitioner at the point of Fellowship 2. RACGP Curriculum for Australian General Practice 2016: Aboriginal and Torres Strait Islander



Page 69 of 70




http://www.racgp.org.au/download/Documents/Vocational%20training/Competency-profile.pdf


Page 70 of 70