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Find out all you need to know to apply for the RACGP Australian General Practice Training Program with JCU. Hear from Dr Maneka Sivakumar, Dr Jacinta Power and Dr Lawire McArther about what it's like to be a GP and how to apply.
Wednesday 8 September 2021
Hosted by JCU, this webinar is for doctors interested in RACGP.
Applications open at 10am AEST Monday 30 August and close at 11.59pm AEST Tuesday, 21 September 2021.
Lawrie McArthur 0:03
Well, welcome all great to have you joining us tonight. I'm Laurie McArthur. I'm the Director of JCU GP training and, and really, this is just a wonderful opportunity to share with you some an exciting opportunity that you have to join the 2022 Australian General Practice Training scheme, and particularly focusing on our GP College of General Practitioners training, and how we deliver that across North West Queensland through the James Cook University General Practice Training Program.
Lawrie McArthur 1:02
the stream. So, I'm going to get started, this is being recorded. So you can always go back, the Michael listened. And first of all, I just want to say, look, if you do choose to do your training, we're trying to help you optimize what you get out of the Spirit, and to be most successful in your fellowship exemptions. Ideally in your first attempt. So that's what we're all about. And, and that in mind, I just think it's great to better welcome to you a couple of perhaps just tell their story about why they chose general practice. So, first of all, I want to welcome Dr. Menaka Suvumar.
Maneka Sivakumar 1:50
Sure. So my name is Maneka, I'm a first year registrar at a clinic in Gracemere, which is just near Rockhampton, I did my internship in Rockhampton three years ago, then I did a JHP and an SHO year in Brisbane and now I'm back on the rural pathway. I thought I would just talk about maybe some things that I was worried about before I had gone into general practice. And then if there's anything else that you can think of that worries you, then we can have a chat about that as well. I guess the first thing that was a bit of a worry that is a really common misconception is that general practice can be a bit of a lonely place in comparison to working in a hospital, I have not had a single day where I've been on my own seeing patients I've had, you know days where Yes, you'll have to see a few patients quite a bit in a row but lots of time to spend talking to other doctors lots of time to spend talking to your nurses, lots of time to spend talking to the allied health in your clinic. And I think that the the impression that general practice can be a bit lonely in comparison to hospital medicine often comes because people think you just sit in your room and that's it, but that's really not common in general practice at all. Your day is often mixed between yes, seeing some patients, but possibly doing some procedures as well, you know, you're going to walk out into the waiting room, check on some people, so your day is really going to be all over the place.
Another thing that I think that I was quite worried about before I had started GP training was what happens if I get bored. And that's something people always ask me. So I spent my last year in emergency. So I was used to being around a lot always having to run around, do things be very busy. And a lot of people ask me, why are you going to GP? What if you get bored? When you're on a rural pathway, and when you're in a clinic that's in a regional area it is you will not get bored. So the things that I used to do in emergency I still do in my clinic. And that's something that I never ever thought would happen. Things like you know, I used to work at the paediatric emergency at Prince Charles and suturing a child's laceration was such a big deal over there. But now in my clinic, we just do it, you know, we hold the kid down, do some whatever we need to do for pain relief, and we just get it done. And these are all things that I never thought I would be doing in a clinic but here I am doing them. Another example I can think of is I had a seven year old man who had fallen off a ladder and he walked into the clinic because he trusts the clinic as the place that he would go to to see someone. This guy ended up with three pelvic fractures, lacerated liver, nine rib fractures, and he was sitting in my clinic room, you know, this is someone who had to be transferred to ICU straightaway. So after I had experiences realize that it is extremely, extremely difficult to get bored in general practice. And I think that's the biggest benefit of being on the rural pathway. I to be honest, don't know what it would be like to be on the general pathway to maybe be in an inner city hospital where or any city clinic sorry, where you have a hospital right next door. But in regions where I am at Rockhampton, you've got a hospital that's already kind of operating at maximum capacity. So as a GP, your job is to do your do your part in the community, see the patients that you can get started on whatever management they require, and then send them off to hospital. The only other thing that I can think of that I was probably a little bit worried before I started General Practice is what a day being a GP looks like. So you know, obviously, we know they see a lot of patients. But what does that really mean? I think in the first few weeks of GP training, I saw maybe one or two patients an hour and at first that sounded really scary to me, I got a little bit scared when another register told me that the expectation, but it goes by really quickly, you've got lots of people to help you, you break up your day, however you would like. So if you're lucky enough to have a supervisor who is supportive, you can choose to do what you would like with your day, which I think is one of the best things about general practice, I often will see one or two patients and then take a 15 minute break, see another few, two or three patients take a 15 minute break. And I'll do that constantly through the day and in the afternoon, or break it up by only seeing about two patients an hour. So I really give myself a lot of time to do some extra reading. If I want catch up on paperwork, do some housekeeping stuff from being a registrar. And it's really depends on what you want to do some registrar's, flip it the other way around, they have really slow mornings, and they really speed it up in the afternoon. But again, it's all up to whatever you feel the most comfortable with. So I think in comparison to when you're a resident, you know, in the hospital, you're used to rocking up to your ATM Ward rounds, being able to decide what to do with your day is a really, really nice thing. And I think once you know what you want, it becomes a really cool thing to be able to make, make those plans. The I guess I can't speak for the general pathway because I don't actually know anyone on the general pathway majority of my resident colleagues that have gone into GP training have been on the rural pathway as well. And I think the large reason for that is because the ability to do so much more as a rural GP trainee, a lot of colleagues that I have are very interested in emergency specialty type medicine. And when your GP training in a regional or regional rural area, you really get the chance to explore that. So I thought I think that's probably the most that I can think of to mention that might be relevant for you all at this stage. But if there's any other questions or anything that you could think of, I'm happy to answer them.
Lawrie McArthur 7:31
Thanks, Menaka. That's wonderful. Share yourself in that way. I really appreciate it. And and so with that in mind, I'm going to someone who has fellowed in the last well recently is now alumni of JCU GP training and, and an RACGP fellow. And pass you over two Jacinta power.
Jacinta Power 7:50
Good evening, everyone. Thanks, Lawrie. So my name is Jacinta Power. I am a GP currently working in an Aboriginal Torres Strait Islander community controlled health service in Brisbane. I was a graduate of James Cook uni medical school and I did my junior doctor years at the Townsville Hospital. And I also was a registrar through JCU GP training and fellowed just over a year ago now. So I guess some of the things that really influenced me in choosing general practice as a specialty came from having done or completed medical school at James Cook University. So I was aware of the values and I guess the underlying values that JCU has, which is wanting to, I guess, train doctors to work in underserviced areas such as rural and remote communities and indigenous communities throughout Australia, throughout Australia, but in particular Queensland as well. And for me, that's, that's my background. So I am an Aboriginal woman I'm from I'm from the Birragubba nation in North Queensland. And I'm from a rural town as well. So seeing that JCU had a focus on rural health and remote and indigenous health as well. It was something that you know, I found was close to my heart and it I knew the some of the medical educators that were working in JCU GP training from when I had completed medical school, and I just knew that their values and I wanted to train under under their guidance because they were GPs that I wanted to be like. The thing for me in choosing general practice over a hospital training was really came down to being influenced by my own family GP. I grew up, I had a family GP who looked after my, myself as a child, my parents and my grandparents even delivered my siblings. And I just thought that was amazing that one person could have such a big influence in, in a community and he had a big influence in my family as well. And that really inspired me to want to be a general practitioner as well, you really get to look after people, right, throughout the different stages of life, you get to implement treatments that you see are a an outcome as well. One thing that I found from working in the hospital is that you might see a patient when they're really unwell. And, you know, they received the acute care, they need them, they're discharged back to their general practitioner, and you don't really get to hear back what happens when they go back into the community. Did your care actually, did it work? Was it the correct way of treating them and when you're a GP, you get to see a lot of those positive outcomes, especially you know, when you treat something, you know, it works. And it makes a big difference in someone's life. It's, you know, it is rewarding to see that you are, you're the one helping someone through some really difficult things throughout their life. And you get to see a lot of positive outcomes, some are not so positive, but it is really good to get to be with someone throughout their different health journeys that they're going through. And I would also like to, I guess, shadow some things that Maneka was saying is that there is such a variety of things that you can do as a general practitioner, you can really find your niche and area that that you like, whether it's mental health, women's health, skin, obstetrics, or you can really, really mould how you want to practice as a GP. And that's so, so evident at JCU GP training, because of the rural training pathways, I also was on that rural pathway. So I can't comment also on the generalist pathway. But the amount of skills that I learned throughout my different rotations, I was in a rural town, so I was an Ingham. And I was in a private clinic in Townsville, as well as another Aboriginal medical service in Townsville, and just the breadth of skills that you get to learn in general practice training. There's so much there definitely isn't boring. And it's it's very exciting. There's no one day that's the same.
Unknown Speaker 12:32
Jacinta that's wonderful. Thank you for that sharing and also Maneka and, and I think it's what's very clear is that doesn't matter where the what's what we're trying to do is help you to be the best possible doctor you can be. And through that three year, RACGP training program, develop the scope of practice, and we do that and, and support you and surround you through people like medical educators like Jacinta now works as, and she particularly works with our Aboriginal registrar's, but also works with all our registrar's around cultural competency development, then we have, you know, a great suite of other registrar's and whatever your interest is, medical educators, whatever your interest is, you know, we have support, and we do that, and so forth. And for someone like myself, I'm a rural generalist, my backgrounds, obstetrics and anesthetics, emergency medicine, mental health, skin cancer management, you know, we can find a mentor that will help you be the type of doctor you want to be, whether it's a GP or a rural generalist. It doesn't doesn't matter if your general pathway a rural pathway, we want to develop you. And so, basically, it's important to understand that we do that through our training region, which is across north western Queensland. Okay, Northwestern Queensland, as you can see on the map there covers right from the southern border of the Southwest Sunshine Coast, all the way north through the inland Central West corridor up to the to the coastal areas and the islands of the Cape and Torres Strait. So we do that through having 11 training nodes. And that's each of those training nodes and medical educators and, and training advisors to help you. But it's a very vast landscape. And each community is unique, and we work closely to help help you be able to work and live and training in those communities. It's probably important for you to understand that you are joining a Commonwealth funded the Australian General Practice Training Program. Now, there are 1500 places a year this is the second and final intake for 2022. So you better get your applications in fairly soon. And we train people to both RACGP and ACRRM, okay, and each College has its own identity, its own vision and philosophy, its own curricula, its own exams, but whatever We do we make sure that you are well prepared for your college RACGP training in this instance, it's important that you understand that there are what we're looking for is your connection to, to a community. And so and so the 11 training regions is, is something you need to be aware of across across Queensland. And we're just one of basically nine Regional Training organisations. And these regional training organisations are contracted by the Commonwealth Government in Australia, to not only select registrars, that are suitable, but to make sure that your training environment is a good positive training environment. So we do that through accreditation of training posts and supervisors. We have a very elaborate placement process where we look at, we asked registrar's, what they're looking for, we are supervisors what they can provide, and we asked training post what they can support and accommodate. And then we take on board those 101 considerations to help find a suitable placement for you, in community general practice, and ask you to interview and explore that for yourself. We do have to make sure that we adhere to the very, you know, strict vocational training requirements of RACGP, and also the Australian College Australian General Practice Training policies. So generally, if you join JCU GP training, you can't then suddenly transfer somewhere else, you can't suddenly go to Sydney. So if you're from Sydney City, that you have to be prepared to move to Queensland, and to live work and train for your training, duration of your training in that area. And if that's not for you, well don't come, you try and join another training program. Or it's competitive, you might not get a place, basically. But if you do come, we'll support you to the hilt. And we support you through providing very structured education, and mentoring. You know, we continually work with you to help you understand how you're tracking how you're progressing, because in a very short period of time, you have to go from someone who knows virtually nothing about general practice, to being an expert to being a specialist to being able to work independently. And you have to be able to cover the very broad curriculum to get there. And so we're there to help you. So it's very important in this selection, that you choose your pathway. Alright. And as a general pathway, you can only do our RACGP.
Lawrie McArthur 17:45
And, and what I would say to you is that you can do that anywhere in our region of Northwestern Queensland. But if you're thinking I'll do it on the Sunshine Coast, I'll just let you know, it's very competitive for Sunshine Coast, and there is absolutely no guarantees that you would be allocated to the Sunshine Coast training, no rural pathway. Similarly, you can basically do anything anywhere in our region, because virtually all of our region meets that rural modified Monash classification of two to seven. And you do have the option two, if you wanted to, to do an extra year in RACGP training to do an advanced rural schools training post. And in in an area like, you know, I did, for instance, anesthetics. And then to be eligible for with some extra work to a second fellowship called the fire GP fellowship of this rural general practice. But let's keep it simple. That's if you like the FRACGP a bit like the cream. So at the end of the day, this is a three year RACGP training program. And if you go to the next slide, you'll see that the basically the first year, you must do what's called a core hospital year. Now that has to be in time a pgy, two level equivalent year or greater. And you must, by the end of that time have covered for mandatory training requirements. Okay, and I'll come to that next. The second year. And the third year, I basically made up of a minimum of 18 months clinical placement in a community general practice where you're working alongside a supervisor who is like your consultant, and a team of supervisors of other people that you can ask, and you're learning the not only the science and the knowledge and the skills for general practice, but you're learning the, if you like the professional elements as well. So the core competencies around you know, attitudes and approaches and and follow up in that longitudinal care. There is an option to do a six months Extended Skills. And that can be either done in the community general practice, and it can be done in an area like palliative care or mental health. Or it can be done in a hospital setting. The one thing to say about the hospital year is that you can get what we call recognition of prior learning. And I'll talk about that in a minute. And so, you know, one of the key questions for many of you, is that yes, you can join RACGP in your intern year, knowing that your next year will be a pgy, two year. But the big question is, if you're doing that, then how can you make yourself GP ready? Or are you GP ready already, because you've already been working for a few years in the hospitals. So the next slide shows you what's called the mandatory hospital requirements. Now, this is what's dictated. This is strict RACGP directions that all doctors doing GP training must have done a 10 week term in general medicine, general surgery, emergency medicine, and Paediatrics. Okay. And the reason the pediatrics is asterixed is, that's the one term that most doctors struggle with, because all of you will have done those other terms in your intern year. And we also asked for a degree or the RACGP demands that you have sort of widest breadth of general medicine, or met other medical disciplines. So they also ask that you have, you know, some further additional terms, you don't have to do them all beforehand. In fact, I believe if the best place to learn general practice is in general practice. And so we do a lot of work with each registrar in a pre entry meeting, to help understand what you have done and what could be credited towards what we call recognition of prior learning. And so recognition of prior learning basically means that you can suddenly on selection, change a three year training program to a two year training program. But it's really important that, that you have the documentation for that, and that that medical experience is in Australia, okay, we can not count overseas experience in any way. And that needs to be really probably within the last five years. Okay. So if you've been in the situation where you haven't worked clinically for five years, then that's what you then you'll need to think about going back into the hospital. Or occasionally we can look at if you got missing an area, is there an alternative way with the RACGP College censors approval, that you could gain that key competencies.
Just to knew who's doing the great support and the slides tonight, just put up I saw the reference in the racgp website where you can find out more about that. So typically, let's talk about community general practice payments, placements, typically, you know, for a registrar in the first month or a few months of of GPT One we call that training term, you know, will will be orientated into the practice, they'll, they'll have a supervisor who explains how the practice runs, you'll be taught bads by the practice manager how to use the practice the patient management system. And, and you'll be inducted into various you know what the practice nurse or other people in the practice can offer as a service to their patients to their community. You'll be consulting patients virtually from day one. And initially we start a bit slower. But there's also opportunities to be, you know, consulting patients in other settings. It might be if you're in a rural placement, you might also be involved in the rural hospital and admitting patients to the hospital inpatients and doing a ward round. It might be nursing home visits or I'm caring for someone in who's in palliative care. A lot of the teaching is what we call parallel consulting, or co space discussion or corridor conversation about I've just seen this child with red bulging eardrum. I believe it's otitis media, you know, I'm not sure which antibiotic to use. And the supervisor will say, Well, you know, let's use the resource of a therapeutic guidelines, which you may or may not already be familiar with, what's the most suitable antibiotic in the community for that? And here is the important thing with a childhood is that it's a milligram per kilogram dose for amoxicillin. We also have a very blended education program. And, and that blended education program means that every fortnight is what we call a half day release where you get together with A small group of your colleagues at a similar level of training. And you go through a very structured tutorial program to help you cover across the breadth of the rcgp curriculum. We also have workshops, generally there face to face workshop. But obviously with COVID, we sometimes pivoted to be online, or distance delivered. And generally there's, you know, a two day workshop a each semester, we also provide other more focused workshops, they might be in emergency skills, for instance, or procedural skills. And then, but we appreciate that a lot of your teaching actually occurs in practice. So in your practice, to then have dedicated teaching time with one of your supervisors or someone in the teaching team within the practice. So and on top of that you have, we have a learning platform called My JCU GP, which is full of absolutely resources to help you around various clinical topics. Or as you get closer to your exams, maybe even a study guide and, and how to help you prepare prepare for your exams. It's full of videos of how to do procedures, for instance, in a step by step approach, and of course, as an RACGP registrar, you will be a member and have access to the RACGP learning portals as well, which includes access to various articles, Australian family physician, or they call it now Australian Journal of general practice, and in things like a Check program, which is an exam bank.
So it's, it's important though, you are responsible for your own study, you don't get study leave. You are paid, you're essentially being paid by the federal government through a Australian general practice training, and through Medicare, consulting, to learn. Okay, and so you are responsible for your fellowship exam preparation. Okay. So we'll have questions at the end, if you like. But let me just take you through just quickly the application, the Nationals application process and selection for for this round. All right, this is for the 2022 AGPT intake, it's open now it closes on Tuesday, the 21st of September. And you must, you're responsible to apply to that RACGP direct, and to provide different pieces of supporting documentation, including a CV, including your residency if need be. And I would say that JCU doesn't accept temporary visa holders, we only accept applicants who have permanent residency at the time of application, you got to pay a fee $725. And then there's a national process that involves RACGP reviewing the eligibility. And then the plan is that you then do a written exam called the CAT on those dates. Though, I would just say to you watch this space, because I think that may they are racgp may be canceling that cat. And based on the discussions with them this week. And then we have RTO interviews to help you be suitable. The multi multiple mini interviews, they're called. And they occur. Basically, this is like I call it speed dating, if you like it's speed selection. So you have six to eight stations, generally of 10 minutes duration, we deliver this way you wherever you are online via zoom. And and then you're given a scenario or a question, given two minutes to read that and make some notes about how you respond. And then you have eight minutes where you give your answer or response to an interview. And the interviewer is backing you against very various national selection criteria, of which the next slide was very clear, we're very transparent, what we're looking for. All right, what we're looking for is what makes a good GP. Alright, and what makes a good GP, is someone who's a good communicator, someone who's clinically competent. So you can show clinical reasoning and able to manage the undifferentiated patient, perhaps someone who's a good person who can work in a team. So manage conflict, for instance. And someone who very much is a doctor for the patient, that if you want to make money and be rich, then you know general practice is not the highest paying medical discipline. So but we are there with the rewards come in general practice is that you become part of the community, your patients, you form a very significant relationship with really it's a privilege. You know, and I still love consulting, because I love hearing patient's stories. And I love finding ways that I can all journey with them and walk with them and assist with them. So that's I guess what we're looking for. And then after the mini mental state, or mini mini mental state, the multiple mini interviews, then there's a degree of ranking, because it is a competitive process. And then on the basis of the ranking, you are then made training offers offer by the racgp, to your region that you've preferenced despite, you know, positions pending, and that's done by 29th to November. So if you guess if that's just takes you quickly through the RACGP approach to the National 2022 final intake for GP training, and now's a good opportunity to ask, are there any questions? There is one in the Q&A section or if you can see that. Yeah, I can see that. And that was about thanks, Christine. That's about the five year recency of practice. Look on the very much the face value of what you're saying there is that when you're in that five to 10 year range of recency, what we can do is try and gather as much information as we can around that, including statements of service, any evidence of indeterminate assessments you had, for instance, and put it to the sensor to see if there's a way that you could meet some alternative learning requirements.
But that is then totally at the racgp, Queensland sensors discretion. And you can still apply now for GP training. And you can still, you know, apply for a hospital job to help you get that result. So you're practicing those mandatory rotation. And in fact, being an RACGP registrar will probably help you in whatever hospital because you can be a little bit more demanding and say, Actually, I need this for my fellowship training program. And each hospital is more obliged to provide it. But you can't fulfill GPT. One in the hospital? No. GPT. One is strictly a community based general practice term. Okay, I hope that answers your question, Christine. And looking at the chat from bH, can I apply now, if I'll be getting my registration in July 2022? The short answer is you need to have full general registration when you apply well, and by the time you start your training, you know, so that points that you're probably an intern, so the answer is you would need to wait into next year. All right, folks. Well, that probably brings us into the end of tonight. And I just thank you for making the time as I said, this would be recorded and will be up on certainly the JC ugp website. And, and we are more than happy to just get in contact with us. There's there was the last page of the slide gave you the email address, which then you can put in there as email@example.com or you can ring 07 555373 4413 or just look us up on the website JCU GP training. Okay, fantastic. Thanks, folks. Thanks so much for Jacinta and Maneka for sharing your wonderful stories. Every time I hear them, I'm inspired. And and to to all you potential prospective applicants out there will be we'll be thrilled to see you and to get to know you better and and help you achieve your ambition to be the best possible doctor you can be.