Training transition could boost Top End numbers

The first RACGP Northern Territory chair hopes the training shake-up will usher in a new era.

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As the un-democratically elected leader of the royal college’s fledgling Northern Territory chapter, Associate Professor Sam Heard’s first priority is boosting GP registrar numbers in the top end.

Ordinarily, faculty chairs are elected via vote by the faculty council. Without an elected chair, a faculty is unable to perform any business.

In the case of the Northern Territory, which has always been part of the South Australian faculty, there was no faculty council to do the voting of the chair. At the same time, the ouroboros of bureaucracy meant it couldn’t elect a council without a chair.

Which is how Professor Heard, who was just one of a group of motivated doctors who have lobbied for a separate NT faculty for years, found himself appointed as the inaugural faculty chair.

“We’ve been advocating for a couple of years pretty strongly to get the faculty in time for training,” he told The Medical Republic.

Other members of the group included NT RTO chair, Associate Professor Emma Kennedy, as well as Marrithiyel woman Ada Parry, who works with the RACGP as a cultural and education advisor.

“I was elected by that group of motivated GPs, but not by every GP in the Territory,” he said.

Professor Heard’s title is technically interim chair, at least until the first regular election in November next year.

His first order of business will be overseeing the transition to profession-led training in February. The outgoing RTO, NTGPE, will leave big shoes to fill.

“It’s had quite a good impact in terms of the numbers of registrars in the territory,” Professor Heard said. “We peaked about five or six years ago at about 60 registrars.”

Registrar levels have dropped off over the last several years as the training transition loomed.

“We’d normally have 14 registers with us at any time [at the practice I’m at] and across our 11 other clinics,” said Professor Heard. “But next year, we’ll have about four.”

The return to a nationally centralised training scheme will allow registrars to move more seamlessly across state borders, which Professor Heard hopes will work in the Territory’s favour.

“Once the [RTO-based training] program came in, everyone had to commit for three years to the Territory, which is a big ask,” he said.

“People did do it – but quite a lot of [the registrars] want to do something a bit more adventurous.

“Before we had NTGPE, the majority of registrars came during training, rather than starting in the Territory.”

Professor Heard also hopes to foster a different style of learning environment.

“The RTOs have had a pretty didactic approach to training,” he said.

“It’s been about teaching people ‘what to do in this instance’, but if you think about being a generalist … the amount of knowledge you need now to do anything, is an order of magnitude [more complex].”

“Just for diabetes you’ve got about 50 drugs to choose from now, instead of just insulin.”

Generalism, Professor Heard believes, is not meant to be a “crammed head” profession.

“It’s not going to be just a training program, for me,” he said. “It’s going to be the profession pulling together and really supporting registrars and supervisors.”