2 October 2020

Colleges to lose control of GP training

ACRRM Education KnowCents RACGP Rural

The Department of Health has hit the brakes on returning training to the colleges next year in a shock move that appears to have taken the RACGP, ACRRM and regional training organisations by surprise.

The Department of Health announced it would be exploring different operational models for general practice training at a meeting held earlier this week between the leaders of various RTOs.

The proposed scheme would remove GP training from the general practice workforce and could include trainees and their supervisors being remunerated by the government, instead of under the current practice model.

In a letter to its members, the RACGP said it had been proceeding with the expectation that it would soon be signing the funding agreements needed for the smooth transition of training to the college by the end of 2021.

“However, it is now clear the Department of Health is seeking a new approach to the training transition,” said Dr Tess Van Duuren, RACGP’s acting censor-in-chief.

The RACGP said it understood that the Department of Health would still make the colleges responsible for training registrars from selection through to fellowship.

But it seems the transition will no longer be as smooth as the college expected.

“What seems to be at the heart of this shift is the Department of Health has come to realise the transition of GP training is an important opportunity to ensure that the Australian General Practice Training Program and other related workforce programs are fit for purpose and cost-effective,” said Dr Van Duuren.

The Medical Republic understands that a key goal of the department is to improve the distribution of GPs, particularly in rural and regional areas.

But Dr Nicole Higgins, chair of General Practice Supervisors Australia, said the result of this decision by the department was that training would “move from being GP-led to GP-delivered”, meaning the RACGP would not have control any more.

Dr Sama Balasubramanian, president of General Practice Registrars Australia, said it was important that the changes took into account the voices of trainees and supervisors.

“We want to make sure that the potential benefits are realised and that any downside risks are avoided so that no GP trainee, or supervisor, is adversely affected during the transition or beyond,” he said.

But under the proposed changes, the department may be trying to solve the rural and regional workforce shortage by assigning trainees to a location of their choosing.

Dr Ian Kamerman, a GP supervisor and chair of GP Synergy, said he was nervous about this proposed solution from the government, which might force registrars to go rural.

“I don’t know how you do that and at the same time make general practice an attractive and popular specialty, because 20 years of evidence tells us that all it does is push [junior doctors] into non-GP specialty training,” he said.

“The other thing I’d say to the department is that if you actually want to make general practice an attractive proposition for medical graduates, [fund] Medicare so that it supports the concept of general practice,” he said.

An example is the recent Medicare changes that demoted GPs’ role in interpreting ECGs, another move which Dr Kamerman said reduced the attraction of training in general practice.

The colleges and RTOs are now awaiting further advice from the department, but say their priority is still to ensure minimal disruption to the delivery of training.

TMR put a series of questions to the Department of Health, but there was no response before deadline.

COVID-19 live update