codes, principles and recommendations - gp...

GP Synergy

Codes, Principles and Recommendations


For training posts and trainers

VERSION CONTROL NUMBER 14

Date of revision: 22 January 2016

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Preface This Codes, Principles and Recommendations document is aimed at supporting supervisors and training practices to evaluate their capacity and preparedness to engage with GP Synergy as a general practice training practice. It is also aimed at providing helpful information in the promotion of the training practice.

A sound understanding of registrars’ training needs and proper exercise of trainers’ responsibilities will promote clinical safety and a positive training experience for the practice and registrar. Requirements and expectations of training practices and supervisors fall into three categories:

Codes: Minimum training standards and requirements that trainers and training practices are required to meet.

Principles: Principles are advisory, however if they are not followed they may require an explanation as to why.

Recommendations: Helpful suggestions based on GP Synergy’s experience and expertise in the promotion of the training practice environment.

Codes

Principles

Recommendations

Codes (training standards) are specified in a clear and concise way to ensure that the minimum responsibilities of training practices and trainers are clearly understood and that training practice and supervisors are adequately informed to determine their readiness, willingness and ability to meet those standards as a minimum requirement.

Principles are advisory however, if they are not followed they may require an explanation as to why. Training practices are requested to ‘‘comply or explain’’ by publishing reasons as to why they may have departed from the principles in their practice profile. Alternatively the matter may be raised as a point of discussion during reaccreditation as these principles reflect good practice. The practice profile is a public document and may be referred to by trainees when considering whether to apply to the practice for a training position. A proper review of the principles will ensure the training practice has considered the implications of each and has made an informed decision about any departure from those principles.

Recommendations are advisory only and are aimed at assisting the training practice in its promotion of a quality training improvement. There is no requirement to comply or explain against the recommendations.

The very real pressures for medical workforce can sometimes overshadow the responsibilities and risks inherent with general practice training. It is our experience that when training practices approach general practice training from the dominant workforce perspective, adverse situations are likely to occur. General practice training must be approached as a reciprocal arrangement that protects and benefits the training practice, the registrar and patient. When this occurs the benefits of workforce and positive experience of general practice training are likely to follow.

This Codes, Principles and Recommendations document will evolve over time to reflect ongoing developments in the general practice training environment.

John Oldfield | Chief Executive Officer

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Codes

Minimum training standards and requirements for trainers and training practices

Codes hereafter may refer to the following:

Training standards as set by the professional colleges including the Royal Australian College of General Practice (RACGP); and the Australian College of Rural and Remote Medicine (ACRRM)

The GP National Terms and Conditions for the Employment of Registrars (NTCER) which are updated annually by negotiated agreement between the General Practice Registrars Association (GPRA) and the National GP Supervisor Association (NGPSA)

Standards for training providers as they may affect the training practice or supervisor.

It is important that practice staff and supervisors are fully aware of these standards as non-compliance is monitored by GP Synergy and may adversely affect the status of the training practice’s accreditation, its reputation amongst registrars and its ability to attract trainees into the future.

Code 1: Employment of the registrar

The training practice will ensure that GP registrars are employed by the practice under a written employment agreement. GP registrars may not to be regarded as self-employed or contract workers. Where exceptional circumstances require this requirement to be modified e.g. for Visiting Medical Officer (VMO) status at some rural hospitals, GP Synergy must be notified of such circumstances.

Apart from legislative and regulatory requirements, the following conditions of employment of GP

registrars must also be observed:

a) The employment agreement must satisfy the GP National Terms and Conditions for Employment of Registrars (NTCER).

b) Rostering of GP registrars for both ordinary and on-call hours must be equitable (in

comparison to other doctors in the practice) and where possible developed in

consultation with the GP registrar.

c) Receipts to the training practice for VMO services which are carried out by the GP registrar will form part of the gross receipts for the purpose of calculating minimum salary payable the GP registrar (as applicable). Conversely payments received by the GP registrar for VMO activity will form part of the calculation of base rate paid to the registrar for the purpose of calculating minimum salary levels for the GP registrar.

d) For the calculation of registrar salaries, please refer to the latest iteration of the NTCER.

This document is reviewed every year.

Code 2: Indemnity, registration and liability

All GP Synergy registrars are required to undergo health workforce screening checks before initial clinical attachments occur. GP Synergy facilitates this process between the NSW Office of the Children's Guardian or Access Canberra and its registrars. GP Synergy will notify the relevant practice of any issues that may arise from an employment screening check and that have material effect on a placement in that practice.

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The training practice is reminded that it may be vicariously liable for the actions of its employees. GP Synergy endeavours to ensure that registrars have:

a) Medical registration b) Medical indemnity cover; and

c) A Medicare provider number for the duration of the term (it is the registrar's responsibility to

apply for and ensure that their provider number is current).

It is the training practice’s responsibility to confirm that the registrar’s indemnities are current at the time of employment of the registrar. GP Synergy does not warrant that these registrar’s indemnities are in place at the commencement of the training term as GP Synergy has no control or involvement with the approval process.

GPRime provides facility for recording Medicare provider numbers (by the GP registrar only) and for recording Prohibited Employment Screening validation numbers (by authorised GP Synergy staff only). In both cases the currency of these requirements are reported in GPRime under the portfolio view of the applicable GP registrar.

Code 3: Pre-existing personal relationships and the employment and training of registrar trainees

The relationship between the training practice (including its trainers and staff) and the trainee is

fundamentally a contract of employment and contract of training service delivery which are part of a

nexus of contracts between the training practice, GP Synergy and the trainee. The employment and training of those who have a pre-existing relationship with a person(s) working in the training practice (particularly if those staff act as a supervisor) has the potential to lead to conflict and poor training practice as a result. Whilst GP Synergy does not prevent employment relationships of this kind, it does take a particular interest and oversight in these known employment relationships to ensure they are properly managed.

In the event of this situation, the training practice must ensure that:

a) All codes and principles contained in this document are strictly applied to the training

placement in accordance with the trainee’s stage of training. This requirement is applicable no matter what the type of pre-existing relationship may be (i.e. relatives, partners, friends or others).

b) The training practice and trainee must both sign a contract of employment. This must be

completed prior to the commencement of training and a copy of the employment agreement must also be provided to GP Synergy. For this purpose you will be prompted to upload an electronic copy of the employment agreement whilst finalising placement advice on GPRime2. GP Synergy may veto placements where there is a departure from minimum requirements. The contract of employment must specify the following conditions of employment agreement (as a minimum):

Terms and conditions:

The contract of employment must specify terms and conditions, including remuneration, superannuation, rostering and provisions for leave applicable to the stage of training. These conditions must accord with the most current iteration of the NTCER at the minimum.

The applicable terms and conditions must be written into the signed contract of

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employment before the placement may commence.

Registrar and supervisor wellbeing:

The trainee, supervisor and affected staff have reflected on and agreed to how they will address any conflicts of interest that might arise with respect to the placement.

The agreed processes must be written into the signed contract of employment before the placement may commence. Agreements must detail with whom the practice staff, supervisor and trainee should communicate if problems arise. The process must also include how the parties will deal with matters of patient safety, patient complaints or clinical incidents.

Education and training:

The training practice and trainee have considered the requirement and benefits for trainees to be exposed to other practices to gain a wider range of experience in other settings. The parties agree that the placement does not impede this requirement and acknowledge that the trainee has/will gain wider exposure to other clinical settings during the course of their training.

Feedback and formative assessment:

The supervisor and practice staff commit to providing GP Synergy with timely and accurate formative assessment of the registrar’s strengths and areas for improvement. Conversely, the trainee commits to reporting accurate and timely assessment of the performance of the supervisor and practice.

c) The training practice acknowledges and accepts that if conflicts arise or if GP Synergy

becomes aware of poor training practices relevant to the placement, GP Synergy at its own discretion, may intervene. Intervention may include termination of the placement or training time without compensation. In such cases GP Synergy will place the trainee in an alternative training practice of its choosing.

Code 4: Supervision and teaching responsibilities

Initial induction requirements for newly accredited GP supervisors

It is a requirement that all supervisors must complete GP Synergy’s ‘initial induction program’ before

engaging with general practice training. Due to timing of programed events and the placement

process for GP registrars, it is sometimes the case that training practice contracts are issued prior to

the supervisor completing the required initial induction program. This may only occur on the expressed understanding that the supervisor commits to completing all program requirements before the training placement commences. GP Synergy provides flexible options to complete this requirement.

Where newly accredited supervisors fail to meet this requirement, GP Synergy may at its own

discretion do any of the following:

a) terminate the placement prior to the commencement and re-allocate the registrar to

another training practice

b) deal with the matter under GP Synergy’s compliance framework, which may result in conditions being placed on the supervisor’s accreditation certificate, or prevent the supervisor from participating in future rounds of training placement until the matter is resolved.

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On-site and off-site supervision requirements The summary below specifies the minimum on-site and off-site supervision requirements for registrars at their respective stages of training. Remedial training is addressed by agreement with GP Synergy under a training plan on a case by case basis.

Code 4 - Supervision and teaching responsibilities

GPT1 Trainee GPT2 Trainee GPT3 and Extended

Skills Trainees

Standard / Code

reference

a) Placement time

RACGP: 26 weeks

ACRRM: 24 months total training time, which may include

hospital, general practice, community and other practices

RACGP: 26 weeks

ACRRM: 24 months total training time, which may include

hospital, general practice, community and other practices

RACGP (GPT3): 26 weeks

(Extended Skills): 26 weeks

ACRRM: 24 months total training time, which may

Include hospital, general practice, community and other practices.

RACGP

3.3.1.1

ACRRM Policy on PRRT

b)

Weekly on-site supervision requirement

Supervisor co-located for a minimum of 80% of the trainee’s time.

Supervisor co-located for a minimum of 50% of the trainee’s time

Supervisor co-located for a minimum of 25% of the trainee’s time.

RACGP 1.2.1.2

ACRRM 7.2.4, 7.2.2

c) Weekly off-site supervision requirement

Must be available by phone or make arrangements for another recognised general practice supervisor to be available, including after hours.

Must be available by phone or make arrangements for another recognised general practice supervisor to be available, including after hours

Must be available by phone or make arrangements for another recognised general practice supervisor to be available, including after hours.

RACGP 1.3.2.3

ACRRM 7.2.4, 8.7.3

d) Weekly in-practice teaching requirement

Minimum – 3 hours per week.

1 hour of which comprises formal set aside teaching

Minimum – 1.5 hours per week.

1 hour of which comprises formal set aside teaching

None required however, ‘corridor’ support is required.

RACGP 2.2.1.2

ACRRM 7.2.3

e) Supervisor on leave

Must provide alternative support



RACGP 1.2.1

ACRRM 7.2.4, 8.7.3

f) Critical incident reporting

Training posts must report to GP Synergy any critical incidents relating to a registrar working in the practice.



RACGP 1.3.1.2

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Supervision requirements for Visiting Medical Officers (VMOs)

It is the responsibility of the training practice to ensure that GP registrars are supervised when acting as a Visiting Medical Officer (VMO). For the purposes of VMO work:

a) The training practice must ensure that a nominated supervisor is made available to the registrar.

b) If required, the nominated supervisor (or appropriate delegate) must be available to attend and assist the registrar in person.

A Service Level Agreement between a GP registrar and Local Health District established for the purposes of delivering VMO services is not an employment contract between the Parties. Nor does it supersede the employment contract established between the GP registrar and the training practice.

The conditions and obligation of this Agreement remain in force for the purposes of VMO services provided by the GP registrar in the same way they apply to community based supervision and teaching. When a GP registrar is engaged in VMO activity, the training practice remains responsible to ensure the level of supervision provided to the GP registrar is the same as that prescribed in the table above.

PLEASE NOTE: GP Synergy requires the training practice to ensure that appropriate supervision is provided to the registrar when on-call. The level of supervision needs to be commensurate with the registrar’s stage of training and individual competence. This will require GP supervisors, in conjunction with the registrar (and GP Synergy if required), to determine the registrars’ readiness to participate in the on-call roster and negotiate an appropriate Agreement regarding on-call arrangements to ensure neither Party is dissatisfied. In circumstances where such Agreement is not able to be reached, intervention by GP Synergy will be necessary.

Matters of registrar well-being or performance

Supervisors must communicate with GP Synergy medical educators about concerns they may have for GP registrar well-being and performance. In the event that the supervisor has concerns about the registrars well-being or performance which is unlikely to be remedied in the normal course of training, the supervisor must contact the medical educator who is assigned to the GP registrar to inform them of their concerns

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Code 5: Training and education activities

The following summary specifies key education and training activities depending on the term type. It

also provides reference to the applicable college standards for the respective vocational endpoint. GP Synergy provides a number of resources and supports that will assist supervisors and practices in achieving the requirements including eLearning resources.

GPT1 Trainee GPT2 Trainee GPT3 and

Extended Skills Trainees

Standard / Code

reference

a) Provide orientation and induction support to the registrar

At the commencement of the placement



RACGP: 2.2.2.1 ACRRM: 8.3.1

b) Review of registrar competency prior to commencement

Review of prior registrar assessments to match in-practice supervision and teaching according to registrar requirements



RACGP: 1.1.1.1 ACRRM: 7.2.6

c) Assist the registrar in the review and development of a learning plan.

By week 4 of each 6 months of training



RACGP: 1.1.1.3 ACCRM: 7.2.6

d) Monitor and manage workload

No more than two to three patients per hour average at least eight patients per session

No more than four patients per hour average at least eight patients per session

No more than four patients per hour average at least eight patients per session

RACGP: 2.2.2.2 ACRRM: 8.5.3

e) Formative (Competency) assessment

Complete three formative assessments of the registrar: Beginning mid - term: and end of term (is accepted towards in-practice teaching time)

Complete three formative assessments of the registrar: Beginning mid - term: and end of term (is accepted towards in-practice teaching time)

Complete two formative assessments of the registrar: Mid-term and end of term (is accepted towards in-practice teaching time)

RACGP: 1.1.2.1 ACRRM: 7.2.7

f) Educational release in-hours of practice

GP Synergy’s mandatory education requirements



NTCER GP Synergy education activity requirement documents

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GPT2/PRRT2Trainee

Code 6: Receipts and payments

The following table specifies the payments made by GP Synergy to the practice for its distribution and the minimum payments that training practices must make to GP registrars.

The requirements below reflect current industrial and employment related conditions and are subject to change without notice. Minimum terms and conditions for the employment of registrars are updated annually. Changes to practice subsidies and teaching allowances may be periodically amended by GP Synergy and will come into effect for future placements and contracting periods only.

GPT1 Trainee GPT2 Trainee GPT3 and Extended Skills Trainees

Standard / Code reference

a) Payments made to the practice by GP Synergy over a full training term or, pro rata as applicable for 24 weeks of the 26 week placement.

Practice subsidy: $14,560 Teaching allowance: $9,936 ($138 per hour)

Practice subsidy: $7,280 Teaching allowance: $4,968 ($138 per hour)

NA Pro rata by monthly instalments in arrears subject to acceptance of contract. Figures quoted are ex GST and are subject to change without notice

b) Minimum salary payments made by the training practice to the GP registrar or, pro rata as applicable

$74,215 ($1,427.21/week), plus 9.5% superannuation; OR 44.79% of in hours gross billings or receipts, plus 9.5% superannuation, calculated over a 3 monthly cycle inclusive of leave taken. Whichever is the greater amount

$89,226 ($1,715.88/week), plus 9.5% superannuation; OR 44.79% of in hours gross billings or receipts, plus 9.5% superannuation, calculated over a 3 monthly cycle inclusive of leave taken. Whichever is the greater amount

$95,295 ($1,832.60/week), plus 9.5% superannuation; OR 44.79% of in hours gross billings or receipts, plus 9.5% superannuation, calculated over a 3 monthly cycle inclusive of leave Whichever is the greater amount

NTCER 2015-2016 iteration (subject to change annually)

GP Synergy pays an hourly rate for attendance at specified professional development activities. Other

sub-contracting arrangements for GP Synergy are also paid including: agreed remedial work, acting as a

clinical teaching visitor, delivering lectures and facilitation, and other.

Hourly rate

Comment

a) Hourly rate for GP supervisor payments for prior approved work and professional development

$138 Approval for paid works and specified professional development activity is at the discretion of GP Synergy.

Figures quoted are exGST and are subject to change without notice.

b) Hourly rate for sub-contractor travel

$69 Travel time is reimbursed at 50% of the extant hourly rate subject to certain conditions.

Please refer to the GP Synergy External Contractors Remuneration Contract for further details

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GP Synergy issues a contract to training practices for each training placement. In doing so we will issue a Recipient Created Tax Invoice (RCTI) at the same time reflecting practice subsidy and teaching allowance for the placement type and duration.

c) The Training Practice must not invoice, or make monthly claims for practice subsidy or

teaching allowance payment.

d) Upon acceptance of the practice contract for the respective training placement, GP

Synergy will schedule monthly progressive payments to the Training

Practice. Progressive payments are made one month in arrears form the date of

the commencement of training placement.

e) Payments are made to the Training Practice by Electronic Funds Transfer (EFT). It is the

responsibility of the Training Practice to maintain the correct banking details in GPRime within its practice profile on GPRime2.

f) The Training Practice must make its own disbursements of teaching allowances and subsidies under its own internal arrangements.

PLEASE NOTE: It is important that the Training Practice establish internal delegations and processes for the execution of agreements with GP Synergy. It is acknowledged that agreements entered into by employees, officers, or agents of the Training Practice are binding on the Training Practice.

g) Payments are issued by GP Synergy on the basis that the GP supervisor meets their

teaching, support and development obligations including review and signing of the GP registrars practice logs and completion of the relevant GP registrar’s formative assessments.

h) Payment for attendance at GP supervisor development activities will be paid separately to

this Agreement and upon RCTI as issued by GP Synergy.

i) In the event that a Training Practice Contract or RCTI is incorrect due to data error or

system error or does not accord with the schedule above, GP Synergy reserves the right to revoke, amend, and re-issue the relevant Training Practice Contract and RCTI.

It is agreed that:

i. GP Synergy can issue tax invoices in respect of the supplies

ii. the Training Practice or its agents will not issue tax invoices in respect of the supplies

iii. the Training Practice or its agents acknowledges that it is registered for GST when it enters into

this Agreement and that it will notify GP Synergy if it ceases to be registered; and

iv. GP Synergy acknowledges that it is registered when it enters into the Agreement and that it will

notify the supplier if it ceases to be registered for GST.

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Code 7: Privacy

Introduction

The Training Practice and GP Synergy Limited will be regulated by the Privacy Act 1988 (Cth) and the

Health Records and Information Privacy Act 2002 (NSW). In this document, these Acts, their privacy

principles and the regulations and codes made under them are collectively known as ‘Privacy Laws’.

The Training Practice will ensure that it and its staff, supervisors and GP registrars comply with the

Privacy Laws.

GP Synergy will ensure that its staff comply with the Privacy Laws. GP Synergy maintains a privacy

policy on its website. The privacy policy has more detailed information which explains how GP

Synergy:

protects the personal information of individuals (including staff, supervisors and GP Registrars) GP Synergy works with

collects, uses and discloses personal information provided to us or collected from others

allows persons to access/correct their personal information

manages complaints.

The Training Practice acknowledges and accepts these uses and disclosures of personal information.

Use of personal information by GP Synergy GP Synergy collects personal information about GP registrars, GP supervisors, practice managers

and agents of the Training Practice.

GP Synergy will generally only use personal information for the primary purpose for which GP

Synergy collects the information (set out below) or a secondary purpose related to the primary

purpose which an individual would reasonably expect GP Synergy to use the collected information.

GP Synergy will make the individual aware of the purpose for which GP Synergy collects personal

information by notifying the individual about all the relevant matters of that collection.

GP Synergy will not use an individual’s information for an unrelated secondary purpose unless GP

Synergy obtains the individual’s written consent or a permitted health situation under the Privacy

Laws applies.

GP Synergy collects personal information:

to deliver the Australian General Practice Training Programme

to develop educational content and determine the distribution of GP registrars

to report under contractual arrangements to the commonwealth Department of Health

to pursue collaborative projects with other health industry stakeholders

to distribute information about GP Synergy’s activities and publications by way of direct

communications/marketing to train GP registrars, improve our health system and improve the

health of our clients

to undertake internal research on a de-identified basis.

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Disclosure to third parties by GP Synergy

GP Synergy will only disclose an individual’s personal information:

for the primary purpose for which it was collected

for purposes related to the primary purpose

when permitted by the Privacy Laws

with the individual’s consent

when needed for law enforcement.

In the course of our activities, GP Synergy may disclose an individual’s personal information to

collaborators, contractors, consultants, banks, accountants, lawyers and insurers. This is done only

when appropriate and on a need-to-know basis. GP Synergy takes steps to ensure that those

persons keep that information confidential and delete the information when it is no longer needed,

where possible.

In the course of delivering training, GP Synergy works closely with related industry organisations and

may disclose limited contact details of GP registrars or GP supervisors for education purposes or

health workforce development purposes.

In the course of conducting research, GP Synergy may disclose statistics regarding individuals on a

de-identified basis to Primary Health Networks (PHNs), Local Hospital Districts, medical colleges,

commonwealth or state departments, the NSW Rural Doctors Network, and other related

organisations.

Code 8: Breach of agreement

If the Training Practice or GP supervisor considers that GP Synergy has breached this Agreement and has not been able to resolve the matter between the relevant people involved, it may escalate the matter through GP Synergy’s grievance process. Please refer to GP Synergy’s Grievance Policy.

If the Training Practice does not provide the services stipulated in this contract of Agreement they will be considered to be in breach. In such cases GP Synergy will issue an observed non-compliance and will compliance management processes. If the matter remains unresolved GP Synergy may take one or more of the following actions:

a) endorse the current service arrangements as appropriate in the circumstances b) provide additional support for the registrar, supervisor or practice having difficulties c) counsel the registrar, supervisor or practice d) re-allocate the registrar e) issue a notice to show cause that may result in termination of accreditation as a Training

Practice or GP supervisor under GP Synergy’s objective test policy and process.

PLEASE NOTE: If a breach is found to have occurred and cannot be reasonably remedied and where payment for the supply services has been made under the RCTI, GP Synergy retains the right to ‘claw-back’ these payments equal to the proportion of services not supplied.

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Code 9: Dispute resolution

Disputes are usually resolved by discussion between the relevant staff of the Training Practice and staff of GP Synergy. In cases where conciliation has not been reached, GP Synergy provides a framework to support aggrieved trainers and training practices through its grievance policy.

If GP Synergy is aggrieved by the performance of the Training Practice staff or supervisors, it will

escalate the matter with reference to the following steps:

a) When non-conformances are identified, GP Synergy will issue a notice of non-

conformance and will seek response by the Training Practice or supervisor.

b) Where serious breaches are identified or termination of a contract or

accreditation certification is being considered, management will escalate the

matter through GP Synergy’s Objective Test Policy and process to protect the

safety of trainees, or public, or where the integrity of the training program. In

doing so an Objective Test Committee is convened to make a final ruling on the

information provided. Please refer to GP Synergy Objective Test Policy.

PLEASE NOTE: GP Synergy will issue a show cause notice to the Training Practice or supervisor inviting written response to the Objective Test Committee. The show cause notice will outline details of the proposed action being considered which may include termination as a Training Practice or GP supervisor.

The Objective Test Committee has the discretion to make a determination on the information provided

or may seek further information by interview.

Code 10: Termination

a) This agreement may be terminated by either Party by giving four weeks’ notice in writing.

b) Where serious breaches are identified GP Synergy reserves the right to terminate the

agreement or training placement without notice to protect the safety of trainees or public.

c) Practice subsidy and teaching allowances are tied to the GP registrars training term and employment. Payments are suspended during time of approved leave (such as maternity leave) or discontinued upon termination of employment.

Definitions

Term Description

Australian General Practice Training

(AGPT)

The formal vocational training program undertaken by GP registrars seeking to specialise as general practitioners.

General Practice Term 1 (GPT1) Previously named the Basic General Practice Term which is the first six months (or full time equivalent thereof) of community based general practice training.

General Practice Term 1 (GPT2) Previously named the Advanced General Practice Term which is the second six months (or full time equivalent thereof) of community based general practice terms.

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Australian College of Rural and Remote

Medicine (ACRRM)

The Australian College of Rural and Remote Medicine is the professional organisation sets the standards for general practice education and training for GP registrars who are engaged in reaching ACRRM fellowship (FACRRM) which is the end point of this training program.

Royal Australian College of General Practitioners (RACGP)

The Royal Australian College of General Practitioners is the professional organisation sets the standards for general practice education and training for GP registrars who are engaged in reaching RACGP fellowship (FRACGP) which is the end point of this training program.

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

The most recent Agreement brokered by the Australian Medical Association (AMA) between the General Practice Registrars Association (GPRA) and General Practice National General Practice Supervisors Association (NGPSA), including any amendments made during the term of the contract

GP registrar A doctor enrolled in Australian General Practice Training (AGPT).

GP supervisor A vocationally registered general practitioner who is accredited by the relevant college as a trainer and supervisor of GP registrars and other medical trainees.

Training Practice

(Also referred to as “the Practice”)

A community based general practice that is accredited by GP Synergy (under its delegation by the respective college) for the purposes of general practice training.

Medical educator An employee of GP Synergy Limited, with responsibility for planning, supporting and monitoring the training of GP registrars, supporting training practices and GP supervisors.

Medical educators design and deliver educational activities for GP registrars and GP supervisors.

GPRime/ GPRime2 General Practice registrar Information Management and Education (GPRime) is GP Synergy's on-line learning management system.

Return of Service Obligation (RoSO) RoSO is the policy requirement that ensures registrars complete a quantum of their training time in designated areas of medical service need as determined by GP Synergy and the Commonwealth government.

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Principles

Principles are advisory in nature, however if not followed practices are required to explain why. Principles are advisory however, if they are not followed they may require an explanation as to why. Training Practices and supervisors are requested to ‘‘comply or explain’’ by publishing reasons as to why they have departed from the principle in their practice profile. Alternatively the matter may be raised as a point of discussion during reaccreditation as these principles reflect good practice.

The practice profile is a public document and may be referred to by trainees when considering whether to apply to the practice for a training position. A proper review of the principles will ensure the training practice has considered the implications of each and has made an informed decision about any departure from those principles.

Principle 1: for new trainers and training practices

If your facility is new to general practice training it is important to start with a more experienced trainee to gain confidence and insight.

As part of this process, training practices should:

a) Satisfy themselves that they have relevant and current experience as a teaching facility to ensure that trainers can fully commit their time to balance the clinical workload and case mix applicable to the trainee whilst effectively managing their own clinical workload and personal responsibilities.

b) Ensure that immediate pressures and demands for workforce do not ‘blind’ decision making.

An inability to meet the required codes of practice may result in a trainee being removed from

a training placement. It is detrimental to all concerned to terminate training part way through

a training term. Despite adverse effects on the trainee who is then ‘out of a job’ and training

position, the training practice will likely suffer reputational damage, may face industrial dispute and may have funds clawed back by GP Synergy under the contractual engagement. The practice may find it difficult to regain accreditation status and/or attract future trainees.

c) Safety for patient and registrar is paramount. The practice must satisfy itself that it has contingencies in place to support training for the whole of the training term that they commit to. Unsupported training may lead to patient complaint and dissatisfaction and reputational damage to your business, or even adverse health outcomes for patients.

Principle 2: Continuing professional development

Although it is a requirement to complete GP Synergy’s initial induction program before engaging with general practice training, it is encouraged that the supervisor undertake ongoing continuing professional development that is relevant to the role of supervisor and educator.

GP Synergy provides a range of workshops and flexible models of supervisor professional development that is targeted at different levels of competence and experience. As part of this process, supervisors are encouraged to:

Engage with GP Synergy’s supervisor development programs. GP Synergy is certified to provide

these programs with continuing professional development (CPD) points attached including flexible

options to complete this requirement. They include:

a) attending paid supervisor professional development days b) attending the special supervisor weekend workshop (not paid, however travel,

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accommodation and addendums are supported) c) the provision of paid Clinical Teaching Visits for GP Synergy d) engaging with GP Synergy’s as a paid facilitator or presenter in the delivery of formal

education programs

e) establishing a registrar’s lesson plan derived from contemporary CPD activity with alternate

providers

f) other.

For further information, please refer to the GP Synergy Supervisor Professional Development

Requirements and Activities program. (This document will become available early 2016)

https://gpsynergy.gprime2.com.au/Documents/HtmlDocument.aspx?docId=20448&id=21541&latest=true

https://gpsynergy.gprime2.com.au/Documents/HtmlDocument.aspx?docId=20448&id=21541&latest=true

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Recommendations

Recommendations based on GP Synergy’s expertise and experience GP Synergy has developed the following recommendations for training practices based on our expertise and experience in prevocational and vocational education.

Practices are not required to follow these recommendations however the suggestions provided

are aimed at assisting the practice and supervisors.

Recommendation 1: Setting up and managing your practice profile

Your practice profile is an important source of reference for registrars when making application. It is important that your profile is accurate and reflects your practice in its best light. If circumstances change, please be sure to update your profile to keep it current.

Tips when updating your practice profile

Tip Description

Concise Keep content concise and relevant to your audience.

Teaching experience Emphasise any previous experience in teaching.

Exam preparation assistance Have any of your supervisors had experience as an examiner in RACGP and/or ACRRM fellowship exams? Does your practice offer any other exam preparation assistance?

Special interest / extended skills opportunities

Does the practice offer any special interest areas? Could your practice offer placements as Extended Skills (ES) terms?

Clinical exposure What types of cases/presentations could a registrar expect to encounter at your practice? Do you have any unique patient demographics? Are there nursing home visits/other clinics?

Practice culture What’s it like to work in your practice? i.e. friendly staff, flexible working environment, staff lunches, journal clubs, casual Friday, etc.

Supervisor biographies Include information about each supervisor such as qualifications, special interests, maybe even a short quote from the supervisor explaining why they enjoy being involved in GP training.

Location advantages Proximity to transport links, shopping/dining facilities, parking, etc.

Past trainee testimonials

Collect testimonials from current and past trainees and seek their permission to publish on your profile.

Unique aspects Accommodation subsidies or provision, flexible working hours, professional development opportunities, etc.

Photographs Include photographs of your practice and its facilities on your profile. GP Synergy can arrange to take photos at your practice.

GP Synergy


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Recommendation 2: Engaging with GP Synergy as an advocate or educator

GP Synergy supports the role of GP Supervisor Medical Educator (GPSME). This role provides academic and project opportunities for supervisors who have a specific area interest in general practice education. This is also a good way to work with us and consider further involvement as a medical educator. Please contact us for more information.

Recommendation 3: Vertically integrated teaching and training

Vertical integration of general practice education and training is the coordinated, purposeful, planned system of linkages and activities in the delivery of education and training throughout the continuum of the learner’s stages of medical education’.

The aim of vertical integration (VI) is to have a clear pathway across the learning continuum from undergraduate to practice vocational training. The implementation of VI is a way to reduce the load on our GP clinical teachers and improve the training experience for both teachers and learners.

Katrina Anderson, “Vertical integration – reducing the load on GP teachers”.

Australian Family Physician Vol. 38, No. 11, November 2009

For further information, please refer to the following article by Katrina Anderson: Vertical integration – reducing the load on GP teachers

http://www.racgp.org.au/afp/2009/november/vertical-integration/

http://www.racgp.org.au/afp/2009/november/vertical-integration/