The GPRA president says it’s still unclear how much will change and that the college will be facing questions in the new year.
The colleges are confident the transition to college-led GP training in February 2023 will be a smooth one, but the peak registrars’ body still wants to know more.
Half of the respondents to a survey of registrars released this week said they did not understand the transition process.
Before the release of the survey, The Medical Republic asked new RACGP president Dr Nicole Higgins what the transition would look like. She said she hoped that building on the existing regime would allay concerns about disruption in the new year.
“We have designed our delivery operating model, working closely with training organisations, so we can build on the approaches that are working well to ensure a smooth transition,” said RACGP president.
“Almost 700 staff have been recruited directly from existing registered training organisations nationally. In most cases our training model will increase local training facilities and staff numbers in communities to support GPs in training even more effectively.”
Dr Higgins said the model was based on local delivery teams, which would be supported by state, territory and national leadership and support teams.
“We really value the contribution of GP Synergy, who we’ll continue to use for training delivery, as well as the other training organisations which have been supporting the transition,” Dr Higgins added.
However, Dr Antony Bolton, president of GP Registrars Australia, said trainees still need to know more about the placement process.
“Registrars need to know how they’re going to be able to choose where they work,” he said. “At the moment, the suggestion from the college is a matching process, but no detail about what that means. And not everybody under current arrangements uses a matching process – some people have a relatively open-market approach.
“Others have a very controlled kind of matching process, where there’s only a couple of options. It varies between RTOs (regional training organisations).
“The view from the college that we’ve heard so far is that nothing will change,” Dr Bolton said, “but we currently have nine different systems going into one or two systems, so something has to change for somebody and we’re still a bit unclear about how that’s going to work.”
Returning GP training to the colleges has involved some major financial changes. ACRRM and the RACGP established an incorporated joint venture, Joint Colleges Training Services, to deliver AGPT training program services.
“The RACGP signed the single largest medical vocational contract entered into in history by an Australian government, and we received major grant income as part of this,” Dr Higgins said. “However, the transition is an enormous program of work with associated costs. And we are well aware of the privilege of being responsible for GP training, and how critical it is to get this right.
“We are also working to create efficiencies where possible, and this includes via a solid technological infrastructure that will free up funding to be directed to where it matters most: training GPs for the future.”
However, Dr Bolton had some concerns about the allocation of funding.
“We know that more funding has been given to supervisors and practices and as an organisation, we fully support supervisors and practices being properly supported financially to host registrars,” he said. “But because we’re talking about a fixed funding pool that the government wouldn’t increase, that inevitably means money taken away from registrars.
“We also know that the flexible payment pool, which you’d hope would cover over those gaps, is going to be used to provide supervisors’ CPD and bridging payments for people who are already in post receiving a certain amount of financial support. It’s our view that there probably isn’t going to be a lot left in that after those two things are done.
“We think registrars should be prioritised through the flexible funding pool, but I just don’t think it’s within the capacity of the colleges, given the money that’s available to them, to actually do that. So that’s an ongoing concern.”
Dr Bolton also said he was looking forward to the colleges’ announcing more details of the dispute resolution process.
“We often have registrars who enquire about particular aspects of the terms and conditions of employment, for example,” he said. “A lot of the time it’s about either the registrar or the practice not understanding how the terms are meant to be implemented.
“We also need to know what to do when a more significant issue arises, such as concerns about clinical care, expressed either by a trainee or a supervisor. Also concerns about billing – such as whether registrars are being given control over their billing. Unfortunately, some of this stuff does end up in a dispute, and we need to know how that process will work.”
Released earlier this week, a report on a key survey of Australian registrars revealed a high level of overall satisfaction with GP training, but also knowledge gaps when it came to the transition.
The AGPT National Registrar Survey is an annual, national survey of GP registrars enrolled in active training on the AGPT program across 11 training regions and nine RTOs. From late June to early August 2022, the survey gathered information via an online questionnaire about registrar satisfaction, experience and future career plans.
More than 4100 registrars were asked to reflect on their recent training experience in semester 1 in 2022. Of these, about 30 per cent provided a valid response.
The survey revealed that overall satisfaction levels in 2022 were consistent with the previous year’s poll. More specifically, 85% of registrars were satisfied with the program’s overall education and training, and support, while 83% were satisfied with its overall administration.
In addition, while 87% were satisfied with the support they received from their RTO to meet the RACGP’s training requirements, only 66% were satisfied with the support they received to meet ACRRM’s training requirements.
That represents a significant drop from the upward trend seen in the past few years: 55% in 2017, 62% in 2019, 78% in 2020 and 80% in 2021, but greater than the pre-pandemic proportion.
Satisfactions levels were even higher – from the high 80s to mid-90s – when registrars were asked to reflect on their experience with their specific training facility, including topics such as supervisor support, quality of clinical work, patient diversity and facility location.
The survey also asked about any changes to training that would follow the transition from health department-led to college-led GP training.
- When registrars were asked if they understood the transition process, 16% said they did, 33% were unsure, and 51% said they did not understand the transition process.
- When asked whether the transition had impacted their training, only 5% replied that it had quite a bit or very much impact, while 42% responded that it had either somewhat or no impact and 52% replied that they didn’t know what impact it had on their GP training.
- When registrars were asked about how informed they felt they were about the transition to college-led GP training 38% said that they were not at all informed while a further 41% replied that they were somewhat informed. Only 12% replied that they were quite a bit or very much informed about the transition process.
- Registrars gained information about the transition to college-led GP training most frequently from either their RTO (63% of responders) or from their own college (42% of RACGP registrars from RACGP, 54% of ACRRM registrars from ACRRM). A smaller proportion had received information from General Practice Registrars Australia (14%), their supervisors or training facility (9-10%) or the health department (3%). Four per cent of responders to the survey said they couldn’t find any information.
The GPRA’s Dr Bolton is hopeful for a smooth transition to college-led training, but anticipates further work will be needed.
“I accept the colleges’ view that they are ready to go in February,” Dr Bolton said, “but I do think there’ll be a rise in inquiries from registrars. And that will be something the GPRA and the colleges will have to work closely together on to manage it effectively.”
