Just back from a two day GP Supervisors conference in Adelaide. Attendance at these events is mandatory for GP supervisors. Training primary care providers for the future in Australia has seen some changes over the years – responsibility for training was removed from the College (RACGP) in 2002 and devolved to ‘regional training providers’ or RTPs, of which there were many across Australia. A criticism of this was duplicaiton of processes and resources for a system which, like other specialty training programmes, could and should be under the control of the College!
A shakeup occurred in 2015, with the culling of many RTPs in an attempt to avoid duplication and the establishment of a streamlined network of ‘regional training organisations’ or RTOs. Needless to say some winners and losers across the nation. They sit under the auspices of the Dept of Health Australian General Practice Training. Again the DOH control the training, although RACGP and ACRRM now determine entry to the programme.
GPex won the contract for South Australia and are now responsible for funding training and ensuring access to training materials, with registrars following either FRACGP or FACRRM pathways.
I will keep my thoughts about the content of the conference to myself as it’s inevitable to compare content with that delivered by other RTOs. Needless to say a good conference combines necessary updates in training requirements with innovative content to help supervisors be more effective in their supervision. Of course other organisations, not least GP Supervisors Australia can help refine supervisor skills….
I see supervision as an apprenticeship – of course it’s necessary to ensure mandatory competencies across the breadth of general practice are met. To their credit, GPex have introduced the ‘GP365’ model of critical case analysis, backed up by development of a personalised learning plan. Of course those registrars on the rural pathway need to bolt on additional skills in emergency medicine as a minimum and perhaps one of anaesthetics, obstetrics or surgery.
Whilst acquisition of either FRACGP or FACRRM is the focus of most trainees, I consider it my duty to inculcate tools for lifelong learning. No surprise that this leads my trainees into discussions on metacognition, on heutagogy, on FOAMed and so on.
Many of my supervisor colleagues will invariably be keen to develop skills on how to give feedback, on dealing with difficult consultations (prescribing drugs-of-dependence is a common issue) and of course dealing with risk and uncertainty…along with the myriad of complexities around Medicare billing! Much of medical training at undergraduate and postgraduate training is hospital-based…as a consequence new GP trainees are ill-equipped to deal with uncertainty, to made decisions based on limited information with no immediate access to investigations and to practice as “one doctor-one patient-one room”
“Sadly the skill is HARD to do well – but all too easy to do poorly”
I would maintain that delivery of GOOD primary care is an exhilarating blend of risk, uncertainty and good medicine – across the breadth of practice, not the narrow lens of partialist practice.
Of course our colleagues and our patients judge the specialty of primary care according to the lowest common denominator – hence my enthusiasm for initiatives such as FOAMed to broaden corridor conversations and narrow the knowledge translation gap. SoMe platforms such as the closed ‘GPs Down Under’ Facebook group can also help normalise practice amongst disparate practitioners, as well as unite on issues such as the Medicare freeze etc.
GPex does provide a rather excellent ‘GP Supervisors Manual‘ through their online resource package (amusingly called ELMO). Despite this, some new supervisors seem uncertain on how to start off with a new GP reg. A couple of us came up with the idea of a short ‘how to’ guide for ‘unpacking the new GP registrar’.
I bashed this together in the airport on the way back to KI post conference – whilst the content is specific to GPex, it may be of interest to others. It’s tongue-in-cheek and a bit rough and ready…your feedback is appreciated.
Australian College of Rural & Remote Medicine (ACRRM) – http://acrrm.org.au
Australian General Practice Training (AGPT) http://www.agpt.com.au
Common Primary Care Presentations – racgp.org.au/…/common-general-practice-presentations
GP Supervisors Australia http://gpsupervisorsaustralia.org.au
Royal Australian College of General Practitioners (RACGP) – http://www.racgp.org.au/home