Australian General Practice Training (AGPT) program is delivered throughout Australia by 21 regional training providers funded and accredited by General Practice Education and Training Ltd (GPET). The Royal Australian College of General Practitioners and the Australian College of Rural and Remote Medicine award Fellowships and conduct the examinations and assessments for vocational recognition.

GPET Ltd is responsible for management of the training program and for selection of registrars (600 per year at present) at a national level.

Introduction

The following is an excerpt from the RACGP website.

Definition of General Practice in Australia

General practice is part of the Australian health care system and operates predominantly through private medical practices, which provide universal unreferred access to whole person medical care for individuals, families and communities. General practice care means comprehensive, coordinated and continuing medical care drawing on biomedical, psychological, social and environmental understandings of health.

Definition of a General Practitioner in Australia

A general practitioner is a registered medical practitioner who is qualified and competent for general practice in Australia. A general practitioner:
Has the skills and experience to provide whole person, comprehensive, coordinated and continuing medical care; and
Maintains professional competence for general practice

Definition of rural medicine (the following is an excerpt from the ACRRM website)

Rural and Remote Medicine is the body of scientific knowledge underpinning clinical practice and medical service delivery in the rural and remote context. Its aim is to achieve the best possible outcomes in health care.

Cross-disciplinary investigation is implicit to the practice of Rural and Remote Medicine. It presumes an interdependent model of medical service that combines high level competency in primary, secondary and sometimes even tertiary medical care and forms a distinct scope and method of practice. The skill set of Rural and Remote Medicine includes competencies required in general practice in their entirety, therefore ensuring portability and flexibility of medical training and qualifications from rural to urban geographic contexts.

The rural medical practitioner is defined by proficiency in the unique skill set of the discipline. They provide a whole-of-patient, focussed, continuing care that is responsive to the community's needs and circumstances. Rural doctors provide this wide range of services with limited and/or remote access to specialist or allied services and resources. As such, their personal aptitude is often characterised by independence, self-reliance and multi-skilling as well as strong leadership and teambuilding qualities. In certain settings, practitioners must be acutely aware of, and responsive to, the particular community needs, socio-cultural contexts and distinct patterns of mortality and morbidity that typify rural and remote Australia.

The provision of high quality medical care to patients and their families that is delivered (as far as possible) within their local community is a paramount consideration.

Governance Structure of GPET & Trainee Representation

General Practice Education and Training Ltd is governed by a Board of Directors appointed by the Health Minister. There is registrar representation on the Board through the General Practice Registrars Association appointee. Registrars also participate on a number of GPET's program related committees. GPET funds Registrar Liaison Officers in each of its Regional Training Providers who are also members of the Council of the General Practice Registrars Association. Some Regional Training Providers also have registrar representation at the local governance level.

Training

The training program takes 3 years full time for the FRACGP qualification and four years for the FACRRM qualification. A fourth year of rural training is also available to registrars undertaking the FRACGP - the RACGP's Fellowship in Advanced Rural General Practice (FARGP). A registrar in the AGPT program must complete three (for the FRACGP) or four (for the FACRRM) years of work-based training with a regional training provider before becoming eligible for Fellowship. Registrars may sit the FRACGP examinations in their third year of training. ACRRM?

To achieve full registration as a general practitioner, the registrar must successfully complete the training aspect of the program and attain college Fellowship. They are then eligible for the conferment of fellowship and vocational registration.

Rotations

GP trainees are required to complete one year training in a hospital, which may be reduced through accepted prior learning. Rotations are coordinated by the regional training providers. There are mandatory hospital rotations, such as paediatrics and registrars are required to have clinical exposure in a range of areas that will prepare them for training in general practice/rural medicine. The regional training provider assists the registrar to plan and manage their hospital experience.

There are defined sequential terms in general practice, which build skills and knowledge within a supervised practice-based learning experience. These include defined educational inputs against a curriculum guided by the registrar's learning plan, which is developed with the assistance of the RTP Medical Educator.

There are two training pathways in AGPT -general and rural. Registrars are offered places on one or the other depending on their performance in the selection process and their preferences. General Pathway registrars are usually based in metropolitan areas or large regional centres and are required to spend six months training in a RRMA 3-7 location and another six months working in an outer metropolitan area of workforce need. Rural Pathway registrars must do all their general practice terms (usually two years) in RRMA 3-7 locations, which include large regional centres and smaller towns and practices in rural or remote locations. International medical graduates affected by the 10-year moratorium are only eligible to apply for the rural pathway of AGPT.

Recognition of Prior Learning

In order to facilitate efficiency and access to flexible and self-direction in relation to learning choices and time spent in training, registrars may apply for Recognition of Prior Learning (RPL). Previous experience in accredited hospital posts or other posts that may be recognised as relevant prior learning for general practice.

All prior learning that meets the RACGP's or Australian College of Rural and Remote Medicine's (ACRRM's) guidelines may be considered for recognition of prior learning. Assessment of RPL is undertaken by the respective College (RACGP or ACRRM).

As defined by the RACGP, currently the maximum RPL credit available towards the AGPT program is up to 12 months hospital experience and up to 3 months general practice experience. As advised by ACCRM, there are a range of criteria with numerical weightings to assess RPL that can be used for credit towards attainment of their Fellowship. As colleges change their criteria for RPL from time to time, up to date information should be obtained from the respective College Applications for RPL must comply with the requirements of the Colleges. In general such documentation will typically include evidence of the relevance of prior learning-to-learning objectives, attainment of the learning objectives, adequate participation in educational activities, and participation in formative assessment. (Consult the relevant college information for further detail.)

RPL may be used for shortening the length of time in training or recognising content of prior learning so that registrar can use the full time they have available in the AGPT program to develop skills in other areas. The capacity for a registrar to shorten their training time is determined by the College Censor.

Flexibility in Training

Part-time training is available - a minimum of 3 sessions per week depending on the approval of the regional training provider. Depending on circumstances interruption to training is permitted for up to two years. Special skills terms are available to registrars with particular clinical interests and also for those interested in academic general practice. Opportunities to learn and work in a range of environments are also available, for example, Aboriginal health.

Assessment

Registrars are involved in assessment during training which is managed by their RTP. There is one final written and one final clinical examination.

Costs

Costs for GP training are met by the government in exchange for a service obligation required of registrars' who meet these by working in areas of workforce need, both rural and metropolitan as defined in the guidelines of the AGPT program. Funding is provided to the RTP to meet the educational and support costs of registrars according to local determined priorities and approaches. Registrars earn a salary through the training practice using the National Minimum Terms and Conditions for GP Registrars as a starting point for negotiations on remuneration.

Registrars must be current financial Associates of the RACGP before enrolling in the College Examination, during the College Examination, and for the award of Fellowship process.

Contact details

The RACGP is based in Melbourne.

Address:
RACGP College House
1 Palmerston Crescent
South Melbourne VIC 3205
Phone: (03) 8699 0414
Fax: (03) 8699 0400
Email: racgp@racgp.org.au
Website: www.racgp.org.au

GPET is based in Canberra.

Address:
Level 3 Perpetual Building
10 Rudd Street
Canberra City ACT 2601
Phone: (02) 6263 6777
Fax: (02) 6263 6788
Email: gpet@gpet.com.au
Website: www.agpt.com.au

ACCRM is based in Brisbane.

Address:
Level 4
410 Queen Street
Brisbane City QLD 4000
Phone: (07) 3105 8200
Fax: (07) 3105 8299
Email: acrrm@acrrm.org.au
Website: http://www.acrrm.org.au