This is a live document which contains hyperlinks to websites, documents, policies and email contacts. Please always refer to this electronic version on the MCCC website.

Date of effect: 17th June 2021

Introduction

Murray City Country Coast GP Training (MCCC) is committed to enhancing community health and well-being through leadership in general practice education, training research and workforce development for GP registrars training with MCCC on the Australian General Practice Training (AGPT) Program.

This policy handbook sets out the requirements for GP registrars training with MCCC on the AGPT program, practices and posts that employ registrars to undertake their training within their facilities and GP supervisors that oversee the registrars training.

How to use this handbook

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Acronyms and definitions

The following acronyms and definitions are used frequently within the policies in this handbook. Please familiarise yourself prior to reading the policies or refer back as required.

Selection Procedure

Last updated: July 2020

Relevant resources

• RACGP – AGPT Selection Policy
• ACRRM – Eligibility for Training Policy
• General Practice Training in Australia – The Guide
• RACGP – Selection Guide for Entry into 2021 AGPT Program

1. Purpose

Entry into the Australian General Practice Training (AGPT) program is a competitive, multi-phased, transparent and merit-based selection process.

Murray City Country Coast GP Training (MCCC) ensures the selection process stands up to the scrutiny of external regulators in respect of human rights and anti-discrimination. Specifically, the process is:

Procedurally fair.

Transparent and defensible.

Non-discriminatory.

Free of bias.

The Selection process for the AGPT program consists of three stages:

Stage 1: Application and eligibility.

Stage 2: College assessment.

Stage 3: Regional Training Organisation (RTO) and training region placement.

Further information about the selection process can be found in the AGPT Applicant Guide.

2. Scope

This procedure applies to all RACGP applicants for selection into the AGPT program with MCCC.

ACRRM administer their own interview process with support from MCCC interviewers. Details of ACRRM’s process is available on their website and are not detailed in this procedure.

RACGP’s Selection Process describes the first two stages of selection of applicants.

This procedure refers only to Stage 3: RTO and training region placement.  By this stage an ‘applicant’ is referred to as ‘candidate’.

3. Procedure

Stage 3: RTO Selection and placement offers

1. MCCC is coordinating the interview process on behalf of the RACGP. Interviews for both colleges will be held on the dates specified on the MCCC website. MCCC will provide information about the Selection process via the MCCC website.
2. RACGP inform MCCC of the names of candidates at a designated time. Candidates who have been shortlisted for interview will receive an email requesting the following:
3. booking their interview time: this will be on a first in basis. A booking confirmation email will be generated automatically to the candidate.
4. There are designated day/s available for interview and all candidates must be available during these date/s. The numbers of days available may change depending on the format of the interview. If a candidate cannot attend, they will need to re-apply to the AGPT program the following year.
5. The interviews for RACGP can be Multiple Mini Interviews (MMI) or Panel interviews. The type will be determined each year.
6. Being accepted into the AGPT program does not automatically guarantee a GP term placement. MCCC will select and offer candidates a training place in the AGPT program on the basis of:
   • Their interview score and the interviewers’ feedback.
   • Complete a questionnaire, “Application to Train with MCCC”. Candidates will be asked to preference the locations and region of their choice. The responses will generate points tallied as the registrar’s Selection and Preference score.
   • If interviews are to be held virtually, the Confidentiality form will also be required to be signed and returned.

AGPT Matched Shortlist Places will be offered to Aboriginal and Torres Strait Islander candidates who have requested priority shortlisting. As with rural Australian Defence Force (ADF) candidates, these candidates will be automatically shortlisted to their preferred region.

Candidates accepted during the AGPT second intake may find difficulty in being placed in a practice and receiving a provider number for the first semester of the following year. MCCC’s mid-year placement process may enable placement during the second semester of that year.

Region distribution process

1. Shortlisted candidates will be asked to preference their desired training locations, through the Application to Train with MCCC questionnaire.
   • Rural pathway candidates, this will be in one of following regions: North East, North West or South West.
   • General pathway candidates, this will be in either the Metro West (Western side of Melbourne) or South West (Geelong only) regions.
2. A list of available training locations can be found on MCCC’s website, under the Registrars tab in ‘Where you can train’.
3. If successful following the interview stage, MCCC will take the candidates’ preferences into consideration when undertaking the process to allocate each candidate to a region.
4. The allocations will be based upon the interview score and their genuine commitment to the region and the number of places available in each region, until a region is full.
5. Once a region is filled with first preference registrars, candidates will then be allocated their second preference, based on score.

Hospital Experience Assessment

1. All candidates should obtain from their Hospital/s or Workforce Manager Statement of Service they will be asked to provide. This information is needed for one of three reasons
   • To assess if you are considered “practice ready (PR)” to commence in General Practice.
   • To assess registrars undertaking Extended or Advanced Skills as they need to be PR to do so.
   • To provide registrars continuing in the hospital setting the following year, with an outline of future requirements to ensure they are Practice ready by either the second semester or first semester the following year.
2. Statements of service – these are letters from the hospital providing dates, duration and disciplines completed.
   • The statement will need to cover all the required core rotations for the college you will train through.
   • Candidates requiring more hospital training may require one statement showing rotations you have completed and another indicating rotations you are yet to undertake but are rostered to complete prior to commencing training.
   • Australian trained candidates will require evidence of 52 weeks (full time equivalent) of hospital time since full general registration and overseas trained candidates must have two years of Australian/New Zealand hospital training

Offers of Training

1. Once the preferences are allocated, offers of training will then be sent out to all candidates.
2. The offer will indicate the region the candidate has been matched to. If a candidate does not wish to accept the offer for the particular region, the candidate will be withdrawn from the selection intake and will need to contact the relevant College/s, with a view to participating in any further intakes.
3. Should a candidate not be successful and does not receive an offer of training, they may be invited by MCCC to participate in any subsequent intakes or interview rounds for any unfilled positions.
4. Should a candidate decline an offer of training, they may reapply to another pathway with MCCC.

Medicare Provider Number Procedure (REVIEW NEEDED)

Last updated: March 2020

A registrar cannot work in a general practice without a Medicare provider number to access the Medicare Benefits Schedule (MBS).

1. Purpose

2. Policy

3. Procedure

Hospital Experience Assessment Policy & Procedure

Last updated: September 2020

Relevant resources

• ED 003 Recognition of Prior Learning for RACGP Registrars Policy
• AGPT Selection Guide for entry
• RACGP CPR Qualification
• RACGP Paediatric Term Requirements
• RACGP Recognition of Prior Learning
• RACGP Basic Life Support and Advanced Life Support Guidance Document
• RACGP Vocational Training Pathway Requirements for Fellowship
• RACGP – COVID-19 information for GP’s in training (Refer section 15 GP Term Readiness)
• Medical Board AHPRA Registration Standard: Recency of Practice
• ACRRM Fellowship Training handbook
• ACRRM Training Eligibility Policy
• ACCRM Training Program Requirements

1. Purpose

To outline the mandatory requirements for AGPT registrars and provide guidance on what will be assessed in determining general practice term readiness.

2. Scope

This policy and procedure applies to all AGPT registrars enrolled in the Australian General Practice Training (AGPT) Program where Murray City Country Coast GP Training (MCCC) is the host registered Regional Training Organisation (RTO).

3. Policy

1. Registrars who are undertaking the AGPT program must hold General Medical Registration at the commencement of their AGPT training.
2. Murray City Country Coast GP Training (MCCC) assesses all registrars’ prior learning to determine their potential readiness to commence training and to enter the general practice training term component of their training program.
3. The “hospital experience assessment” determines the practice readiness of a Registrar and is not an application or approval for recognition of prior learning (RPL). Registrars who have completed PGY2 and above and wanting to commence their training in general practice terms should refer to ED 003 Recognition of Prior Learning for RACGP Registrars and/or ED 002 Recognition of Prior Learning for ACRRM Registrars

Requirements to commence in a General Practice Term for RACGP registrars

1. Registrars must meet the 12-month (FTE) mandatory Postgraduate PGY1 or Intern year hospital requirements as detailed in the key requirements below. This can be done as a 12-month AGPT hospital year or where eligible, they can apply for 12 months of Recognition of Prior Learning.
2. A Basic Life Support (BLS) course completed within the 12 months prior to commencing General Practice term. For RACGP registrars this must meets the requirements detailed in RACGP’s Basic Life Support and Advanced Life Support Guidance Document.   

Exemptions may apply in exceptional circumstances e.g. COVID-19 in accordance with exemptions specified by RACGP – refer COVID-19 information for GP’s in training.

Key requirements

The following requirements apply to all MCCC registrars. RACGP and ACRRM registrars who do not meet these requirements will be required to have further discussions with their RHE or Rural Portfolio Lead ME prior to being able to commence in practice.

A minimum of one FTE year of hospital rotations post intern year (PGY1) must be completed. If the intern year was completed overseas, then two FTE years must be undertaken in an accredited hospital in Aus/NZ.

The hospital rotations (in combination with PGY1) must:

• • Provide the Registrar with adequate exposure to a range of clinical rotations relevant to the discipline of general practice that provide the opportunity to develop the breadth of skills
  • Be sufficient to demonstrate an understanding of safe practice, including the recognition and management of the seriously ill patient, prior to commencing general practice terms. This must include adequate exposure to the disciplines of medicine, surgery, emergency medicine and paediatrics in an Australian or New Zealand hospital.
  • Registrars who have undertaken their internship overseas can apply for terms to be recognised by the RACGP using the “RACGP case studies demonstrating the mandatory term competencies” and “Mandatory term competency requirements – reporting tool for RTO’s”. These forms are available from the REAPS.
  • Be undertaken in an accredited hospital in Australia or New Zealand.

1. If a rotation was undertaken more than five years prior to the start of a general practice term, evidence of competency maintenance is required.
2. Required mandatory hospital rotations (Medicine, Surgery, Emergency and Paediatrics) do not have to be completed before application and entry into the AGPT program however they must be completed prior to commencing general practice terms.
3. If applicants request Recognition of Prior learning in lieu of completing a hospital year within the program, refer to the related RPL policy and procedure

Mandatory Hospital Rotations 

Certain hospital training experience is considered mandatory preparation for the AGPT Program and must be satisfactorily completed before commencing in any GP placements and be undertaken in an accredited Australian and/or New Zealand hospital.

1. General medicine: Preferably general medicine, or, if unavailable, a rotation that offers broad medical experience.
2. General surgery: Preferably general surgery, or, if unavailable, a surgical rotation that covers the principles of basic surgical care.
3. Emergency: A term in an Emergency Department (ED).
4. Paediatrics: Paediatric experience must be adequate to ensure safe practice in this area and for RACGP registrars, this is outlined in the RACGP Paediatric Term Guidance Document. ACRRM registrars must discuss this requirement with the Rural Lead ME or their RHE.

Practice Readiness: Breadth of Experience

In addition to these rotations, GP registrars must obtain hospital disciplines in a variety of other areas to demonstrate a breadth of experience. It is an MCCC requirement that you have at least three (3) other disciplines, to provide the variety of skills relevant to general practice, e.g. obstetrics and gynaecology (O&G), psychiatry, aged care or rehabilitation.  There may be acceptable variations to this which will need to be approved by a Regional Head of Education (RHE).

This experience needs to be adequate in exposure, and recently practised in generalist terms in an Australian or New Zealand hospital. An applicant who has come from specialist training would need to demonstrate updated general experience within the past two to three (2-3) years. Applicants are also expected to meet recency of practice requirements.

An applicant who is not practice-ready can still apply to the AGPT program but will need to complete additional hospital rotations on the program prior to commencement in a general practice.

AGPT Hospital Year  

It is the responsibility of each applicant to secure his or her own hospital rotations if required to undertake further hospital training in the program.

Recognition of Prior Learning 

Please note: The HEA process is not the RPL process.

• HEA is providing information relating to mandatory requirements to be considered practice ready.
• RPL is providing proof of 1 year of Hospital time, there is a separate College application process undertaking on commencement in training.

For RACGP registrars to be eligible for any RPL, they must have completed either a minimum of one year of hospital post General Registration OR a minimum of two years in total of Australian or New Zealand accredited hospitals by the start of GPT1 . These time periods are full time (part time work is calculated pro rata). ACRRM registrars will need to discuss RPL eligibility with their RHE and/or Rural Portfolio Lead ME.

Recognition of prior learning (RPL) may be claimed to a maximum of 52 weeks to reduce a registrar’s overall time in the AGPT program.

RPL is not automatically granted, as MCCC and the relevant College censor need to be satisfied that the registrar has the skills and knowledge to justify shortening training time. There are certain criteria for RPL and it is suggested that this be discussed with MCCC staff.

Applicants and registrars are asked to keep copies of their hospital term performance and assessment reports, as they will be required for RPL applications.

Requirements to commence in a General Practice Term for ACRRM registrars

ACRRM policies do not reference “Hospital Experience Assessment”

This reflects the recognition that some of the registrar’s learning journey can take place in a setting working in a regional or small rural hospital. It is noted that apart from a policy on eligibility for training (see below), the emphasis is on “output” at COT time rather than “input” prior to training commencing, allowing flexibility around the means the registrar gains competence rather than the site in which this is gained.

The ACRRM training requirements are contained in the ACRRM Training Eligibility, and Training Program Requirements documents referenced at the bottom of this policy.

The main differences in approach with assessing terms for Core Generalist Training are-

1. Limited registration (not necessarily general registration) is permitted “providing they can demonstrate their ability to fully participate in and meet training program requirements”
2. Disciplines are not mandated within a single year (the “hospital year” in RACGP terminology) but can be gained progressively through Core Generalist Training time (up to 3 years)

The Fellowship Training Handbook provides a range of options to meet these requirements. This lists a range of “curriculum remediation” means to cover “curriculum gaps” within practice. Experience that is required for fellowship is outlined in the ACRRM Training Program Requirements Policy.

The REAPS process document TO 001 can be used to guide the HEA process.

REAPS will conduct an HEA assessment for terms done by ACRRM registrars prior to entry into Community terms.

There will be a discussion between REAPS and RHEs.

It is anticipated there will be several outcomes of this discussion-

1. Registrars clearly ready to start in Community terms (meeting the RACGP requirements above)
2. Registrars who may not meet all of the RACGP requirements above but for whom the RHE and REAPS feel are ready to commence practice. If desired Lead Rural ME is available to support the decision.
3. Registrars who want the start Community terms but where the REAPS/RHE are unsure about the decision. In this case Rural Lead ME and/or DMET can be involved.

A Training Plan discussion will be scheduled between RHE or ACRRM Training Advisor after the HEA process has been completed and before commencement in Community terms.

4. Procedure

For RACGP registrars

When an applicant is sent an offer to train with MCCC, s/he will be asked to complete a Hospital Experience Assessment via a portal on the MCCC website. The assessment will request details of hospital experience to meet the Mandatory rotations and breadth.

Applicants who are making enquiries prior to applying for the AGPT program may also complete the assessment to obtain more specific guidance on whether they are likely to be able to commence directly into general practice and claim RPL.

Statements of Service (in the form of a letter from the hospital – available from Medical workforce) detailing each discipline undertaken, the start and end date of the rotation, and any leave taken are required as evidence from each relevant hospital. Statements should cover all the rotations to be considered, including those pertaining to breadth of experience.

Applicants may need to provide statements for upcoming rotations for MCCC to assess breath of experience and RPL eligibility. It is essential that MCCC be notified immediately of any changes to future rotations.

MCCC will assess this information and email back a letter to the registrar advising of the outcome of their practice readiness assessment. The process is completed in a timely manner to enable assessment prior to participation in the Registrar Placement process if eligible.

Intern (PGY1) applicants also complete the assessment and will be provided with a letter detailing what required rotations will need to be completed during their “hospital” year on the program.

Basic Life Support

MCCC will send an email to registrars commencing in General practice requesting evidence of completion of a Basic Life Support course within 12 months of the practice commencement date. These are due December 1^st for registrars commencing in February and June 1^st for registrars commencing in August.

For ACRRM registrars

The process will be the same as above. If there are “gaps” (eg in paediatric experience) the options for ACRRM registrars are

1. Spend an extra year in a hospital to gain extra skills (RG Skills Year)
2. Commence in a community term with aims to “remediate” curriculum gaps as per ACRRM Training Program Handbook
3. If interns, PGY2 year may offer experience to fill in “gaps”

These plans are required to be noted in an “ACRRM Training Plan”.  (see guidelines)

The plan can be pre-populated by REAPS with information from the HEA form. The plan is then finalised at meeting between the registrar and the RHE and/or Training Advisor. The Training Plan is a dynamic document that is revisited at each TARM throughout training.

It is a requirement that all ACRRM registrars attend 2 emergency courses throughout training. REST is one of these.

RPL is available for ACRRM registrars. RPL is capped at a maximum of 2 years in Core Generalist Training. Details are noted in Fellowship Training Handbook.

Orientation of Registrars in Training Facilities Policy

Last Updated: March 2017

Relevant Resources

MCCC documents

• Orientation for Registrars

External organisation documents

• ACRRM Primary Rural and Remote Training Standards for Supervisors and Teaching Posts
• National Terms and Conditions for the Employment of Registrars
• RACGP Standards for General Practice Training

1. Purpose

To ensure that the process of orientation of registrars commencing in a training post complies with The Standards of the Royal Australian College of General Practitioners (RACGP) and/or the Australian College of Rural and Remote Medicine (ACRRM), Murray City Country Coast GP Training (MCCC) requirements, and the current edition of the National Terms and Conditions for Employment of Registrars (NCTER)

2. Scope

This document applies to all supervisors, registrars and MCCC staff involved in accreditation of MCCC training posts.

3. Principles

1. RACGP and ACRRM standards require that registrars receive a structured orientation at the commencement in a training post that they have not worked at previously. This applies to all levels of training including: GPT 1/PRRT 1, GPT2/PRRT 2, GPT3, PRRT3, GPT 4/PRRT 4 and ESP.

5. Procedure

1. All training posts will conduct a structured registrar orientation in compliance with The Standards of the applicable College.
2. The orientation will be conducted on the first day of the new training term or, where a registrar commences during a term, on the first day of employment in the post during the registrar’s usual rostered work hours.
3. Orientation must not be conducted prior to the commencement of the term, whether in or out of working hours or while the registrar is still in the employment of another post.
4. A registrar may wish to make an informal visit to the practice prior to commencement of employment, but this does not form part of the formal orientation.
5. In the unlikely event that it is deemed necessary to complete orientation outside the above process, prior approval must be sought from the Regional Head of Education (RHE) in the relevant region.

Supply of equipment in training practices

Last updated: May 2021

1. Purpose

To ensure that registrars and supervisors are aware of the equipment to be supplied and made available in training practices, for the use of the registrar.

2. Scope

This procedure is applicable to MCCC training practices, their supervisors and registrars.

3. Principles

Registrars and supervisors in training practices require clarity about what equipment will be available in training practices and any items that registrars need to provide themselves.

4. Procedure

Equipment to be supplied by registrar

1. Stethoscope

Basic essential equipment is to be available in the registrar consulting room

1. Electronic blood pressure machine or sphygmomanometer
2. Digital thermometer
3. Torch
4. Tongue depressors
5. Aurioscope with adult and paediatric ear pieces
6. Visual acuity chart
7. Weight Scales
8. Height measurement
9. Measuring tape
10. Tendon Hammer
11. Tuning Fork
12. Pap smear equipment
13. Urinalysis
14. Pregnancy test kits
15. Gloves – disposable
16. Sharps disposal container
17. Biohazard waste container

Routine equipment which all registrars should have access to within the clinic

1. PPE
2. Glucometer
3. Pulse oximeter
4. Dermatoscope
5. Blood pressure cuffs – large and paediatric
6. Peak Flow meter
7. Ophthalmoscope
8. Ear Syringe
9. Liquid Nitrogen
10. Dressings
11. Suture kits
12. Sterile Gloves
13. Eye examination kit

Emergency Equipment to be available in treatment/resus room

1. Bag and mask ventilation equipment
2. ECG
3. AED
4. IV access equipment
5. Emergency drugs e.g adrenaline/epipen, ventolin
6. Oxygen

Recognition of Prior Learning for ACRRM and RACGP

Last updated: November 2018

• AGPT Training Obligations Policy 2019 (p.7-8)
• RACGP Recognition of Prior Learning Policy Guidance Document
• RACGP Applying for Recognition of Prior Learning Q&A
• ACCRM Recognition of Prior Learning Policy

1. Purpose

To inform registrars of the requirements and guidelines for the application and assessment of Recognition of Prior Learning (RPL) by the Royal Australian College of General Practitioners (RACGP), the Australian College of Rural and Remote Medicine (ACRRM) and Murray City Country Coast GP Training (MCCC).

2. Policy

Recognition of Prior Learning (RPL) is the acknowledgement of experience, training and assessment that applicants have already undertaken, which may provide exemptions from training time, assessment or other training components as required by the RACGP or ACRRM colleges. This policy informs registrars of the requirements and guidelines for the application and assessment of RPL.

ACRRM 

1. MCCC believes that learning in general practice requires continuous, comprehensive and compassionate contact with a variety of people including patients, supervisors, practice staff, administrative staff and medical educators. To this end, the ACRRM pathway and the MCCC training program are learner focussed and longitudinal, covering many rural sites over 12 months. Registrars will learn together in a cohort that will be relatively stable over a year.
2. In order to assist registrars to gain the most from the MCCC training program, and consistent with the aim above, all ACRRM registrars are required to complete at least twelve (12) months in PRRT 1-2 in a post that fulfils primary/community and hospital/emergency care as listed in the ACRRM Fellowship Training Handbook.
3. Registrars may be granted up to two (2) years’ RPL from the ACRRM Censor. Thus within MCCC a maximum of twenty-four (24) months of RPL will be permitted from within the three components, i.e.
   • Twelve (12) months Core (hospital) and/or
   • Twelve (12) months PRRT 3-4 or
   • Twelve (12) months Advanced Specialised Training (AST).
4. If special circumstances apply, a special consideration application must be sent to ACRRM.
5. If twelve (12) months of RPL under the PRRT component has been granted by the ACRRM censor, e.g. in the Emergency medicine component, then it is MCCC policy that twelve (12) months of PRRT 1 and 2 be completed in an ACRRM-accredited post that provides community general practice, preferably also with hospital and emergency care to that community.
6. RPL for CCT time is not required if registrars joined MCCC at this training stage from 2016 onward.
7. Registrars should become familiar with ACRRM Fellowship Training Handbook documentation.
8. A Training Plan will need to be supplied in conjunction with MCCC to ACRRM as part of the RPL application process.

RACGP 

1. Eligibility requirements: Registrars must have completed either a minimum of twelve months of hospital post General Registration OR a minimum of two years in total of Australian or New Zealand accredited hospital by the start of GPT1 in order to be eligible to apply for RPL.
2. Registrars yet to undertake a post-graduate year (PGY) term (hospital units) in their first year on the AGPT program will not need to apply for RPL. All other registrars need to ascertain what type of RPL they require, e.g. for hospital time, extended skills or advanced training.
3. RPL will only be approved for a total of fifty-two (52) weeks.
4. Should the RPL application once submitted not be granted for the full 52 weeks (ie. insufficient evidence is provided) up to three months of the hospital year can be undertaken in general practice posts, at the discretion of the RACGP Censor. Although RACGP’s policy indicates these posts can be undertaken at any stage of training, MCCC has the authority to nominate the timing of this additional training time. MCCC has mandated this time must be added to the end of the registrars core training time.
5. Once submitted, RPL outcomes may not be amended, augmented or revoked.

3. Procedure

ACRRM

1. RPL can be a lengthy and complex process. The initial meeting between the ACRRM registrar and a Medical Educator (ME) will attempt to create a learning plan that will identify learning goals throughout training time, consideration of an AST discipline and potential curriculum gaps (especially in other disciplines not covered in AST). This will inform an RPL application depending on the registrar’s stage of training and whether the registrar enrolled in ACRRM prior to core clinical training (CCT).
2. RPL requires an assessment and recommendation by MCCC and approval by the ACRRM Censor. Registrars are advised to submit their completed applications within the recommended time lines.
3. Application forms are available on the MCCC website. Applications must be made on the ACRRM Recognition of Prior Learning (RPL) Application form.
4. An application must be submitted to the regional Registrar Education and Practice Support Coordinator (REAPS) within the first two (2) months of commencement of training. It should be completed as early as possible as the outcome will inform a registrar’s training plan.
5. The registrar must return the completed application pack electronically to their regional REAPS Coordinator.
6. On receipt of the application, the REAPS Coordinator will check the documentation is complete and request additional information from the registrar if required.
7. The Regional Head of Education (RHE) or delegated ME will assess the registrar’s application. The application will be assessed in light of the applicant’s knowledge, skills, experience, and training requirements.
8. The completed application, with MCCC’s recommendation, will be forwarded to the Censor.
9. Once ACRRM receives the application, the Censor will conduct a final assessment and make a decision. The Censor will confirm this decision in writing to MCCC, which will inform the registrar of the outcome.
10. If a registrar disagrees with the decision regarding RPL, he or she can discuss their concerns with their RHE.
11. If a registrar wishes to appeal a decision, he or she can lodge an application for a review of their RPL with ACRRM.

RACGP

1. The RPL can be a lengthy and complex process and requires MCCC’s Senior Medical Educators and Director of Medical Education to assess and make their recommendation prior to being sent to the college Censor.
2. Applications must be submitted within the first two (2) months of commencement of training in general practice. It should be completed as early as possible as the outcome will inform a registrar’s training planning.
3. This timeframe is needed to ensure that RPL applications are submitted to the RACGP as mandated by the end of GPT1.
4. Guidelines for RPL are available on the MCCC website. An application for the hospital-based year of training must be made via the online RPL portal located on the MCCC website.
5. There is a declaration form that, which is required to be downloaded, signed by the registrar and a witness and re-uploaded to this portal. The application form must be completed in full and all required documents uploaded.
6. Upon receipt of the fully completed application, the Training Support Officer and REAPS will check the documentation is complete and forward it to the Regional Head of Education (RHE) for approval.
7. The RHE, or their delegate, will assess the RPL application. Applications will be assessed considering the applicant’s knowledge, skills, and experience and training requirements.
8. The assessed application requires final sign off by MCCC’s Director of Medical Education and Training (DMET).
9. The completed application, including MCCC’s recommendation, will be forwarded to the RACGP Censor. The application will outline which posts and how many weeks are recommended for RPL. This may be part, or all, of the time initially requested by the registrar.
10. Once the RACGP receives the application, the Censor will conduct a final assessment and make a decision. The Censor will confirm the decision in writing to MCCC who will inform the registrar of the outcome.
11. If a registrar disagrees with the decision regarding RPL, he or she can discuss their concerns with their RHE.  If a registrar wishes to appeal a decision, he or she can lodge an application for a review of their RPL with the RACGP.

Training Obligations Policy and Procedure

Last updated: June 2021

Relevant resources

ED 008 Registrar Wellbeing Policy and other related Policies/Guidelines

TR 002 Diversity of Training Experience Policy and Procedure

TR 006 Transfer Between Training Pathways Procedure

TR 012 Metro West Outer Metro training requirements and restrictions Policy

Variation to Training Hours Application (called training time)

ACRRM Fellowship Training Handbook

AGPT Training Obligation Policy

National Terms and Conditions for the Employment of Registrars (NTCER)

RACGP Standards for General Practice Training

1. Purpose

To outline the training obligations for registrars who are undertaking the Australian General Practice Training (AGPT) program.

2. Scope

Registrars are required to train in accordance with the policies and procedures of Murray City Country Coast GP Training (MCCC) and the Department of Health (the Department) and the standards of the Royal Australian College of General Practitioners (RACGP) and Australian College of Rural and Remote Medicine (ACRRM).

This policy applies to all registrars enrolled in the AGPT program and seeking endpoint to one of the following: Fellowship of the RACGP (FRACGP), Fellowship of ACRRM (FACRRM) or Fellowship in Advanced Rural General Practice (FARGP).

This document should be read in conjunction with the current AGPT Training Obligations Policy.

2. Policy

Training location obligations

General pathway requirements

Please refer to current AGPT Training Obligations Policy and TR 012 Metro West Outer Metro training requirements and restrictions Policy  for further details.

Rural pathway requirements

1. The rural pathway training location requirements do not apply to the hospital/core clinical training year.
2. Registrars who are subject to Section 19AB of the Health Insurance Act 1973 (the ten-year moratorium) must undertake all of their training, including required skills training, under the rural pathway at facilities located in MMM 2-7 locations.
   • These registrars are not eligible to apply to transfer from the rural pathway to the general pathway unless they are first granted a Section 19AB exemption by the Department.
3. A Section 19AB exemption allows the registrar to apply to transfer from the rural pathway to the general pathway. A Section 19AB exemption does not guarantee MCCC or the Department will approve the application to transfer the registrar to the general pathway.
   • a) MCCC will only consider transfers to the general pathway subject to the conditions as set out in TR 006 Transfer between Training Pathways Procedure, and subject to training post availability.
   • b) Registrars not subject to Section 19AB and training on the rural pathway must also undertake all of their training in facilities located in MMM2-7 locations. However, the TR 006 Transfer between Training Pathways Procedure allows MCCC and the Department to consider pathway transfer applications from registrars so that these registrars may train in an MMM 1 location. These registrars do not require a Section 19AB exemption to support their application.
   • For the purposes of Clauses, a and b above:
4. MCCC may allow registrars to undertake Extended Skills (excluding extended skills in General Practice), Advanced Specialised Training (AST) and/or Advanced Rural Skills Training (ARST) temporarily in MMM1 locations, subject to the following conditions being met:
   • MCCC must document that all reasonable options for rural placements within their training region have been exhausted.
   • Upon completion of this term, the registrar must return to MMM 2-7 training locations.
5. Specific location preference is subject to the following conditions:
   • Registrars on the rural pathway must meet the RACGP Diversity of Training Requirement during Core Vocational Training.
6. With consideration to fatigue management and registrar well-being, registrars on the rural pathway are expected to reside within sixty (60) minutes’ travel time from the practice in which they are placed. Attempting to reside further away than this while training in the rural pathway is detrimental to training and potentially hazardous.
7. Exceptions to training location obligations are set out in the current AGPT Training Obligations Policy.

Training time obligations

1. Registrars should refer to the current National Terms and Conditions for the Employment of Registrars (NTCER) for more information about training time. Note that the NTCER refers to industrial arrangements regarding employment and not training requirements.
2. All registrars commence vocational training at 1.0 FTE (38 hours per week full time equivalent) and are supported to undertake full-time training to obtain College Fellowship (FRACGP, FACRRM or FARGP).
3. MCCC will endeavour to provide access to training at less than 1.0 FTE for those registrars who require this flexibility.
4. Registrars wishing to train at less than full time must apply to their RHE as outlined in 4.4.
5. Training at less than 1.0 FTE can only commence with the prior written approval of the RHE.
6. Registrars will be expected to train at the FTE negotiated during the registrar placement process.
7. Any arrangement for variation of training at less than 1.0 FTE or negotiated during the practice placement process is subject to negotiation between the registrar, the training practice and MCCC outlined in 4.4.
8. Only one application will be considered in any given semester unless there are unforeseen and extenuating circumstances.
9. MCCC advocates that registrars wishing to train less than full time should train to a minimum of 0.5 FTE. Training less than 0.5 FTE may adversely impact on exam readiness. However, minimum training time will be based on the NTCER in line with the College’s
10. Only training activities that have been approved by MCCC will be counted towards a registrar’s FTE.
11. Registrars may work more than 38 hours per week, but this will not accelerate their progress towards Fellowship.
12. Registrars who work for more than 38 hours per week must refer to the following prior to doing so:
    • ED 008 Registrar Wellbeing Policy and other related Policies/Guidelines
    • The NTCER.
    • The relevant Occupational Health and Safety legislation.
    • The Fair Work legislation.
13. Part-time registrars are expected to meet and schedule their out-of-practice educational attendance in their first year of training as if they were training full-time (unless otherwise approved). Part-time attendance at workshops compromises the continuity and educational value of the workshops.

Training time definitions

1. MCCC uses scheduled patient consulting time in a non-workshop week as a measure of FTE. This is because the time released for educational activity and in-practice teaching time varies throughout training.
2. Except in exceptional circumstances (e.g. COVID) full-time general practice experience comprises a 38 hour minimum working week (averaged over four weeks), over a minimum of four days per week, inclusive of:
   • A minimum of 27 hours (averaged over four weeks) rostered face-to-face general practice consultation time (in general practice activities)
   • Admin time (1/2 hour per working day)
   • In-practice teaching time
   • MCCC workshops and webinars (practices release full-time registrars for all workshops and webinars).

   Hours worked beyond the above definition of full-time will not be considered.  Any exceptional circumstances must be discussed on a case by case basis with the RHE.

   Part-time general practice experience is considered pro rata against the definition of full-time general practice experience. Part-time general practice must comprise a 14.5-hour minimum working week, over a minimum of two days per week, inclusive of:

   • A minimum of 10.5 hours (averaged over four weeks) rostered, face-to-face consultation time (in general practice activities)
   • Admin time (approximately 1/2 hour per working day)
   • In-practice teaching time (TT1/2 minimum 1 hour teaching regardless of FTE)
   • Workshop and webinar commitments vary from month to month across the year, but average at approximately 3.5 hours per week. Part-time registrars are expected to attend all MCCC workshops and webinars with their cohort.

   Any exceptional circumstances must be discussed on a case by case basis with the RHE.

   Those seeking Fellowship of the RACGP cannot train at less than 0.3 FTE (14.5 hours over 2 days) as per the college requirements. Those seeking Fellowship of ACRRM cannot train at less than 0.5 FTE as per the college requirements.

Variation to training time procedure

1. Registrars wishing to train at less than 1.0 FTE must then apply to their RHE by submitting a Variation and Verification of Training Time Application Part A at least twenty (20) business days prior to the requested commencement date of the revised FTE.
2. The registrar will be contacted by the RHE and/or REAPS to understand the reasoning for the change and to ensure the registrars wellbeing.
3. If approved, the training time will need to be verified by the practice and the registrar using the Variation and Verification to Training Time Application Part B. This is submitted to the regional REAPS and approved by the RHE.

On-Call Guidelines and Procedure for Registrars and Supervisors

Last updated: January 2019

1. Purpose

Some MCCC accredited training practices require their registrars to participate in an after-hours on-call roster. While on-call, these registrars must be appropriately supervised by a RACGP/ACRRM accredited supervisor who is able to attend the patient, should the registrar require this.

2. Procedure

Where a registrar is on-call or will be rostered on-call during the training term, the following guidelines are applicable:

1. Registrars must have received a thorough orientation to their on-call responsibilities and to the equipment and staff at the Urgent Care Centre.
2. GPT1 registrars should not, unless unforeseen circumstance prevail (such as illness or incapacity of other GPs on the on-call roster), be rostered on-call for at least the first six weeks of the term.
3. The hours a registrar is rostered on-call should not be more onerous than those of other GPs in the practice participating in the on-call roster.
4. Training practices must confirm that all registrars have completed or are scheduled to complete either the REST course or ALS training, whichever is applicable, which is provided to all registrars working in rural areas.
5. Registrars working on-call must be supervised by an accredited MCCC supervisor at all times. Where such a supervisor is working in a different practice to that of the registrar, an introductory meeting between the registrar and the supervisor is advisable prior to the registrar’s first on-call shift.
6. If required, the supervisor should be available to attend on-site to assist the registrar if necessary, within the practice/hospitals usual agreed acceptable on-call distance/time delay. A delay of greater than thirty minutes is not considered appropriate for the safety of patients or registrars.
7. Where on-call arrangements for an area are shared among a number of practices, the registrar, if practically possible, should only see patients of their own practice or another MCCC accredited practice. Supervision arrangements for the registrar should be as above (see 5). Ideally there should be access to medical records after hours from the Urgent Care Centre.
8. The registrar’s usual supervisor should discuss physical safety arrangements with the registrar prior to commencing on-call work e.g. travelling alone at night, emergency contact numbers such as police. Where a registrar is responsible for hospital in-patients (which may occur while a registrar is on-call for the Urgent Care Centre), the supervisor needs to ensure that the details of registrar supervision and indemnity arrangements are clearly outlined in the contract with the hospital. Registrars are advised to view a copy of this contract for inpatient work. The registrar still requires supervision by an MCCC supervisor when on-call for in-patients.
9. On-call rosters need to give consideration of the potential for registrar fatigue. On-call for registrars should not be scheduled overnight prior to a MCCC workshop so as to ensure the registrar is safe to drive and fit to participate in the workshop.
10. Practices need to give consideration to management of practice bookings and workload following an overnight on-call which has been particularly demanding or busy. These strategies should be discussed with the registrar as part of the orientation to the practice and there should agreement from all parties on how these arrangements will be implemented.
11. Registrar on call time spent attending to patients can be counted towards training time and
    recorded as such on recipient created tax invoices (RCTIs). By contrast, on-call time with no direct patient contact cannot count toward training time. The RACGP requires that time spent attending to patients after hours is documented and substantiated.

Additional time spent on-call, when not physically conducting a consultation with a patient, is not included. When practices are calculating this time, the practice software can extract the relevant billing codes and/or billing charges.

Appendix

The applicable after-hours items numbers are:

• After hours home visits: 5003, 5023, 5043, 5063
• After hours RACF visits: 5010, 5028, 5049, 5067 (nursing homes)
• After hours urgent consults at clinic: 585, 591, 594, 599, 600
• Prolonged professional attendance – patient in imminent danger of death 160, 161, 162, 163, 164

Practices could check this in several ways:

• Run an Item or Transaction report for the registrar for the month and then just check how many of these items showed up.
• Do a search for these items or
• Check with the registrar/reception if any after-hours billings took place. This should be noted either in an after-hours log or within the appointment screen

Leave from the Program 

Please refer to AGPT’s leave policy here.

Return to training following absence 

Last updated: June 2021

Relevant resources

ED 005 Registrar in Difficulty Procedure

ACCRM Fellowship Handbook

External related documents

Australian Medical Board “Information on Returning to Practice” Factsheet

Australian Medical Board Registration Standard: “Recency of Practice”

1. Purpose

MCCC GP Training recognises that registrars who have had extended periods of absence from general practice training, may require additional support to facilitate their return to clinical practice and fulfil training requirements. This procedure outlines a standardised approach to the assessment and planning for additional support where required. For the purposes of this procedure, extended leave is defined as a period of time of twelve months or longer from clinical general practice. Extended leave also includes time taken to do Advanced skills or Advanced Rural Skills Training.

2. Scope

This procedure is applicable to all registrars enrolled in the Australian General Practice Training (AGPT) RACGP and ACRRM programs, Regional Heads of Education (RHEs), relevant administrative support officers and the portfolio leads for Registrar Monitoring, Assessment and Progression and Pastoral and Learning Support (PALS).

3. Policy

MCCC GP Training recognises that registrars may take leave or not work in clinical general practice for a variety of reasons, and that there are a number of factors that may affect their ability to transition back into clinical work and training commitments. These include but are not limited to:

• How long the GPR has been away
• Reasons for absence, and potential for this to impact on their return to training
• Were there any concerns about the GPR before they went on leave?
• Has the registrar undertaken any study or otherwise made attempts at maintain knowledge and skills whilst absent?
• Do any workplace modifications or accommodations have to be made?

In order to successfully support safe return to training, MCCC GP Training advocates an early assessment, with subsequent development of an individualized Focused Learning Intervention (FLI) where appropriate, recognising the specific needs of each registrar.

4. Procedure

1. Registrars who have been absent from clinical general practice training for longer than twelve months are identified by relevant administration staff and notified to the RHE. This initiates a process for assessment of the registrar as per Level 2 of the PALS pathway.
2. The RHE (or delegate) will arrange a meeting with the registrar to discuss their return to training and identify any significant issues that may need to be considered.
3. Where the registrar has already matched with a practice, the practice should be advised that the registrar has had an extended period of leave and informed of the assessment procedure. If the registrar has not secured a position, the RTO should assist in facilitating this.
4. The registrar will undergo an assessment, depending on their stage of training:
   • Registrars returning at the start of Training Term 1 (TT1) will undergo Initial Assessment (IA) with the rest of the TT1 cohort.
   • Registrars returning part of the way through TT1 will sit the IA MCQ prior to their return, and have an ECTV, Practice Manager report and Supervisor report in the first two to six weeks of practice.
   • Registrars returning at the start of Training Term 2 (TT2), will sit the Further Assessment (FA) MCQ and clinical reasoning questions (CRQs) prior to their return and have an ECTV, complete a Self- reflection tool (SRT) and Practice Feedback tool (PFT) and Supervisor report in the first two to six weeks of practice.
   • Registrars returning part of the way through TT2 level, will sit the FA MCQ and CRQs prior to their return and have an ECTV, SRT and PFT and Supervisor report in the first two to six weeks of practice.
   • Registrars returning at the start of Training Term 3 (TT3), will sit the Term 3 Assessment (T3A) prior to their return and have an ECTV and Supervisor report in the first two to six weeks of practice.
   • Registrars returning part of the way through TT3 level and beyond, who have NOT passed their relevant college Fellowship exams, will sit the T3A prior to their return and have an ECTV, and Supervisor report in the first two to six weeks of practice.
   • Registrars who return to TT3 and beyond and have passed their relevant college Fellowship exams will require an early supervisor report in the first two to six weeks of practice. They may also require an early ECTV depending on the report.
   • The SRT and PFT can be used as part of the assessment for registrars returning to practice in TT3 and beyond if requested by the RHE.
5. The RHE (or delegate) will review the assessment results and provide information to the allocated Training Advisor to facilitate feedback to the registrar.
6. Early allocation of a Training Advisor is recommended to provide a point of contact and support for the registrar.
7. Registrars returning at the start of TT1 will have a Training Advisor Review Meeting (TARM) in line with the standard IA procedure.
8. For all other registrars, the first TARM will ideally occur in the sixth-seventh week after the registrar re-commences to discuss feedback from the assessment process and review their learning plan and/or FLI where applicable. Additional TARMs may be held as needed.
9. The RHE will involve the local PALS ME if any issues have been identified during the assessment process. Additional assessment may be needed as per the PALS procedure Level 2, to provide clarification of these issues.
10. Where a registrar is identified as requiring additional support, the procedure for PALS Level 3 or 4 should be followed, depending on the additional resources and needs identified.

Extension of Training Time

Please refer to AGPT’s Extension of Training Time policy here.

Registrar Withdrawal (REVIEW NEEDED)

Last update: 

Relevant resources

• ED 005 Registrar in Difficulty Procedure
• ED 008 Registrar Wellbeing Policy
• MCCC Complaint Form
• TR 001 Complaint and Appeals Procedure
• TR 003 Training Obligations Policy
• TR 005 Transfer between RTO’s – In and Out of MCCC
• TR 014 Leave from AGPT Program Procedure

External organisation documents

AGPT forms, including Notification of Withdrawal Application (NOW1) and Review of Decision Application

AGPT Withdrawal Policy

Legislation

Commonwealth Health Insurance Act 1973

Purpose

To set out the circumstances under which a registrar may withdraw or be withdrawn from the Australian General Practice Training (AGPT) program and MCCC GP Training (MCCC).

Definitions

The following definitions apply to this procedure:

Nil

Principles

• This procedure applies to the withdrawal of registrars from MCCC and the AGPT Program.
• MCCC is required to advise the relevant College(s) if notified by a registrar that the registrar is considering voluntarily withdrawing from the AGPT program or if concerns are raised that there are circumstances occurring that could lead to the registrar being withdrawn from the AGPT program.
• MCCC is required to advise registrars in writing that they have been withdrawn from the training program.
• MCCC is required to advise the Department of Health (the Department) and the relevant College(s) within ten (10) business days that the registrar has been withdrawn from the training program by submitting a fully completed Notification of Withdrawal Form (NOW1) to the Department. This notification must include a copy of the formal written notification of registrar withdrawal and any other relevant documentation.
• The registrar will have twenty (20) business days from the date of withdrawal or the date they were notified of their withdrawal, whichever is the later, to lodge an appeal with MCCC against their withdrawal.
• If an appeal is not lodged with MCCC, the Department will formally withdraw the registrar in writing from the AGPT program.
• Once the registrar is formally withdrawn by the Department, the Department will advise the Department of Human Services (Medicare) in writing (emailed to AGPTManagement@health.gov.au) to remove the withdrawn registrar from the 3GA Register under Section 3GB (1)(b) of the Health Insurance Act 1973 if the registrar has an active training placement.
• Once a registrar is withdrawn from the AGPT program by the Department the registrar cannot be reinstated unless the decision is overturned through the AGPT appeals process.
• There are four categories of withdrawal from MCCC and the AGPT program:
  1. Category 1: Voluntary withdrawal.
  2. Category 2: Withdrawal based on clinical competence.
  3. Category 3: Withdrawal based on capacity.
  4. Category 4: Withdrawal based on compliance with education and training requirements.

Category 1: Voluntary withdrawal

• There are two types of Category 1 withdrawal:
  1. Category 1a: Voluntary withdrawal after commencement of training, where a registrar advises MCCC in writing that he or she is withdrawing from the AGPT program after the commencement of training.
  2. Category 1b: Voluntary withdrawal prior to the commencement of training, where a registrar advises MCCC in writing that he or she is withdrawing from the AGPT program prior to the commencement of training.
• Withdrawal under Category 1 attracts a thirty-day cooling-off period to enable the registrar the chance to reconsider the decision to withdraw from the AGPT program.
• The date of withdrawal for Category 1 is the date the registrar notified MCCC of his or her withdrawal from the AGPT program, not the conclusion of the thirty-day cooling-off period.
• Registrars are required to inform MCCC in writing of their voluntary withdrawal from the AGPT program and also submit a completed AGPT NOW1 form to their local Registrar Education and Practice Support (REAPS) Coordinator.

Category 2: Withdrawal based on clinical competence

• Where a registrar is found to be unable to sustain an acceptable level of clinical or training performance to progress with her or his training on the AGPT program within a reasonable time and with available resources, the registrar will be withdrawn. This will be assessed and determined by the DMET, following consideration of other options as listed in section 5: Procedure.

Category 3: Withdrawal based on capacity

• Where a registrar is willing but is unable to continue their training, he or she will be withdrawn.
• Reasons may include (but are not limited to):
  1. Medical registration requirements:
     • Where a registrar has conditions and/or undertakings imposed on her or his medical registration that render her or him ineligible to continue training on the AGPT program, the registrar will be withdrawn.
     • Imposed conditions and/or undertakings could include, but are not limited to, a requirement for Level 1 supervision and restrictions from seeing patients, which could be across all genders or ages.
  2. Withdrawal based on professional misconduct:
     • Where a registrar is found by the Australian Health Practitioners Regulation Agency (AHPRA) to have behaved in a way that constitutes professional misconduct.
  3. Registrars may be withdrawn under this category if a functional assessment as specified in the AGPT Training Accessibility Policy finds that they are unable to meet the education and training requirements of the AGPT program.
     • Registrars may also be withdrawn if the functional assessment finds that they need to be transferred to a different Regional Training Organisation (RTO) and/or pathway to enable them to continue training on the AGPT program and the Department is unable to secure a placement with an alternative RTO.

Category 4: Withdrawal based on compliance with educational and training requirements

• Where a registrar fails to comply with the education and training requirements specified by MCCC and/or the AGPT program and as required by the relevant College(s) standards, the registrar may be withdrawn.
• Where a registrar’s allocation of training time and available extensions (where applicable) are exhausted, the registrar may be withdrawn.
• Where a registrar fails to comply with and complete the requirements of an approved remediation, the registrar may be withdrawn.
• Where a registrar repeatedly fails to respond to correspondence from MCCC relating to their enrolment on the AGPT Program, the registrar may be withdrawn.
  1. Prior to withdrawing a registrar under Category 4, Clause 4, MCCC will attempt to make contact with the registrar a minimum of three (3) times, including once by certified/registered mail.
• Where a registrar is a foreign graduate of an Accredited Medical School (FGAMS) and 457 visa holder is unsuccessful in obtaining permanent residency or citizenship of Australia or New Zealand prior to the completion of their training on the AGPT program, the registrar may be withdrawn.
• Where a registrar cannot meet training time requirements as specified in the TR0003 Training Obligations Policy and/or ED0009 Extension of Training Policy (where applicable), the registrar may be withdrawn.

Roles and responsibilities

• MCCC has a responsibility to:
  1. Monitor the health and well‐being of registrars enrolled in the AGPT program.
  2. Monitor training progress.
  3. Manage training as required by the AGPT program.
  4. Ensure registrars are supported in their training and are able to practise safely.
  5. Protect the integrity of the AGPT program.
• Registrars have a responsibility to:
  1. Monitor their personal health and well‐being.
  2. Check their training progress.
  3. Meet their training obligations and requirements.
  4. Act professionally and responsibly with the training post setting.
  5. Practise competently and safely.
  6. Maintain general registration with reference to recency of practice and continuing professional development registration standards in accordance with AHPRA requirements.
• Registrars will be at risk of being temporarily or permanently withdrawn from MCCC if they are unable to or fail to meet their responsibilities.

Procedure

• Before considering the withdrawal of a registrar from training, MCCC will explore all available possible solutions, including support mechanisms such as detailed in the:
  1. ED 005 Registrar in Difficulty Procedure,
  2. ED 008 Registrar Wellbeing Policy,
  3. ED 009 Extension of Training Policy,
  4. TR 005 Transfer Out of MCCC Procedure and
  5. TR 014 Leave from AGPT Program Procedure.
• MCCC will provide the registrar with the following:
  1. Written notice identifying the matter(s) of concern, the date of withdrawal, details of the appeals process and a request that the registrar show just cause why she or he should not be withdrawn.
  2. A reasonable opportunity to address the matters of concern by responding to the show just cause notice.
  3. An opportunity to discuss his or her withdrawal with the Director of Medical Education & Training (DMET) or delegate.
  4. The opportunity to have a support person.
  5. Twenty (20) days from the date of withdrawal in which to lodge an appeal with MCCC in accordance with the TR0001 Complaint and Appeals Procedure.
• Where a registrar is withdrawn under this procedure:
  1. The registrar is deemed to have been withdrawn from training with MCCC.
  2. The withdrawal process will be documented and will include keeping all relevant records such as meeting notes, formal communications and investigations.
  3. MCCC will notify the Department and the relevant College(s) within ten (10) business days from the date of withdrawal using the Notification of Withdrawal (NOW1) form.

Registrar Learning Needs and Learning Plan Policy

Last updated April 2021

Relevant resources

RACGP Standards for General Practice Training

ACRRM Fellowship Training Handbook

1. Purpose

To describe the requirements for identifying and recording registrar learning needs and suggested methods by which registrars can maintain learning plans.

2. Scope

This policy applies to all Murray City Country Coast GP Training (MCCC) registrars, supervisors and medical educators.

3. Policy

1. A competent general practitioner recognizes that learning and professional development is a dynamic and lifelong process and that learning needs continue to present and evolve throughout a medical career.
2. Planned and proactive self-directed learning is an essential skill all GPs must acquire and maintain. Use of an effective tool to manage learning needs such as a learning plan is highly recommended.

4. Procedure

Maintenance of a Learning Plan

1. All MCCC registrars are required to keep an up-to-date learning plan. It is recommended that the learning plan be maintained on at least a monthly basis. The following information should be recorded in the plan:
   • Identified learning needs: May be required knowledge, skill or experience; should be finite in nature, e.g. “management of melanoma”, not “dermatology”.
   • Proposed learning activity: Description of the activity, e.g. “attend education symposium” or “read relevant journal article”.
   • Record of the activity undertaken: Specific nature of activity undertaken, e.g. “attended GP Dermatology Course” or “Australian Family Physician Article: Chaos and Clues”.
   • Outcome of learning activity: Description of learning achieved, e.g. “understanding of principles of melanoma management in general practice including biopsy techniques, excision margins and referral processes”.
2. The learning plan must be maintained in an electronic format of the registrar’s choosing, e.g. on a spreadsheet, Word document, or within Pivotal. Dates for each entry must be recorded.
3. A minimum of two (2) learning needs and activities must be recorded each month.
4. The registrar is not required to upload the learning plan on to Pivotal. The learning plan does, however, need to be viewed when discussed with supervisors, medical educators and training advisors.

Identifying Learning Needs

1. Registrars identify learning needs as either gaps in knowledge, the need to acquire or hone a skill, or embellish experience. It is recommended that when a learning need is recognized, it is recorded in a notebook or device at the time and then added to the learning plan and addressed when appropriate/convenient. Learning needs can be identified in response to the following:
   • Patient presentations.
   • Assessments/training requirements.
   • Personal interest in a topic.
   • Conscious incompetence.
   • Receipt of reading material.
   • Peer discussion.
   • Supervisor feedback/teaching sessions.
   • Workshops

Meeting Learning Needs

1. It is encouraged that registrars use varied methods for meeting their learning needs. Choice of learning activity should appropriately reflect the required learning outcome. Methods include use of:
   • Medical texts.
   • Medical literature, e.g. Australian Family Physician, How to Treat, Check, Medicine Today.
   • Attendance at educational seminars and symposia.
   • On-line resources, e.g. Dynamed, UpToDate, eTG.
   • One-on-one education with colleagues, e.g. supervisors, allied health practitioners, practice managers, practice nurses.

Recording Learning Outcomes

1. Registrars must record a synopsis of the learning outcomes achieved as a result of participating in the learning activity.

Reviewing the Learning Plan

1. Registrars’ learning plans are reviewed via the following procedures:
   • At each External Clinical Teaching Visit (ECTV) by the visiting medical educator, with the review recorded in the ECTV report.
   • By training advisors at the training advisor review meeting, with the review recorded in the Training Advisor Review Meeting Report.
   • By supervisors throughout the term, with the review recorded in the Supervisor Report twice a term.
2. When the learning plan is reviewed, the educator and registrar discuss the registrar’s choice of learning activity in meeting particular learning needs, and whether learning outcomes were achieved.

Concerns about a Registrar’s Learning Plan

1. It is expected that registrars will:
   • Enter at least two (2) learning needs in to their learning plan per month.
   • Record learning needs that are finite, specific and achievable in nature.
   • Involve activities that are educationally valuable.
   • In instances in which registrars do not maintain a learning plan adequately, the medical educator will give that registrar a period of two (2) months in which to bring the plan up to date. The medical educator will contact the registrar at the conclusion of the two-month period to request the updated document be submitted for review.
2. If the registrar fails to produce a remedied plan, the registrar will be referred to their Regional Head of Education (RHE). The registrar’s progression through, and completion of training may be suspended by their RHE until a valid learning planner is produced.