The switch to college-led GP training should be delayed for up to three years, a Senate committee heard last week – but not everyone agrees.
The transition to college-led training is so opaque and lacking in detail that one regional training organisation has asked for it to be deferred by two to three years, fearing trainees and the rural workforce will suffer.
Dr Tony Sherbon, chair of South Australian RTO GPEx, told a Senate committee hearing last week that his organisation was “sorely disappointed” in the progress being made, with the transition scheduled to occur in 2023.
“We’re deeply concerned about the welfare of trainees and supervisors in the transition process,” Dr Tony Sherbon, chair of South Australian RTO GPEx, told the Senate Community Affairs References Committee in Whyalla, SA.
“We want more information, more communication and more detail about what’s happening. We’d like to see things move more quickly if they’re going to happen this year – but we’d actually prefer a two to three-year delay.
“We don’t feel involved in the process. We’ve asked for plans and documentation that have not been provided by the colleges.
“If we don’t have a smooth transition, [it] will affect the rural GP workforce.”
However, at a meeting of the same Senate committee in Melbourne this week, Penny Shakespeare, deputy secretary of the Department of Health, said the DoH had been doing “an awful lot of work” with the colleges.
“[ACRRM and the RACGP] have access to the greatest detail of that planning because they’re doing a lot of it,” she said. “It’s not necessarily that that information isn’t available to lots of other people; we are working through grant funding approaches, and it’s not something that’s generally made publicly available while we’re still working on agreements.
“We’ve also had particular transition agreements negotiated with all of the existing RTOs.”
Since the government announced the transition to college-led training in 2017, the process has already been deferred by one year, she added.
“I think that was in light of the covid pandemic and the fact that we had a lot of people otherwise occupied and unable to give enough attention to the transition arrangements. However, I don’t think it’s accurate to characterise it as not being well planned.”
ACRRM immediate past president Dr Ewen McPhee told The Medical Republic that the level of readiness varied among jurisdictions.
“Clearly if that RTO is identifying they have concerns about the transition, then that’s a very valid concern,” Dr McPhee said. “Whether it’s applicable across Australia, whether it’s applicable between colleges is of course another matter, but it comes down to [the fact that] this is a big, fundamental shift in focus.
“I think the problem is that we’ve had an inordinate amount of time already and at some point, we have to have a transition point. If we don’t – if we keep pushing it back, pushing it back, pushing it back – we’re never going to achieve it. So, if we push it back, it’s for what purpose, and for what aim and what is going to be different in three years’ time?
“Most [RTOs] have already resigned themselves to the fact they won’t exist at a certain point in time,” Dr McPhee said. “So, for one to say that it wants to push back three years, then what does that mean for everybody else? I mean, it just throws it into disarray. It’s more about sitting down with that [RTO] and saying, what is it that is missing here that you think needs another three years to sort out? And how can that be mitigated through both department and college relationships?”
RACGP President Dr Karen Price said the college was developing its systems, processes and modelling to deliver college-led training from February 2023.
“Ensuring high quality education and stability for all our registrars and supervisors is our priority, and this focus underpins our program design and implementation plans,” Dr Price said. “A strong relationship between each RTO and the RACGP is an important part of the transition, and something all parties remain committed to.
“We all know how big this change is and how important it is to get it right. And we are working to identify areas of the transition where we can work more closely together with RTOs. We know that working together we can build on the successful RTO delivery of the Australian General Practice Training program. We are also meeting with the Department of Health regularly on time-based targets.”
The concerns raised by GPEx’s Dr Sherbon follow a March 2021 survey by General Practice Supervisors Australia in which all respondents nominated their current RTO – followed by the colleges – as the organisation they most trusted to deliver GP training.
The survey also found that between 53% and 78% of the more than 400 respondents were either “satisfied” or “very satisfied” with their own RTO. Nationally, most were “very satisfied”.
However, most respondents also felt they had been inadequately consulted about GP training reforms.
In the 2022 cohort of GPEx trainees, the number that want to remain in the hospital phase of their training, rather than participate in general practice, has increased by 50 per cent. Dr Sherbon suspects this is due to their being uncertain about the move towards college-led training.
“Most trainees and supervisors will tell you they don’t really care who runs the program as long as it’s well run,” he said. “What they will care about is if the transition is poorly executed.”
