Registrar Liaison Officer update
For many of you, we have no doubt that this has been a very challenging few months with enormous changes needed to adapt to the Covid-19 outbreak. All too often as doctors, we neglect our own mental health which can impact on our ability to care for others. We encourage all the registrars to ensure they are taking time for themselves, particularly during this difficult period.
GP Synergy has an excellent wellbeing page with some practical tips and resources that may help. In addition to the resources listed below, another important resource to remember is the Drs4Drs support line which is an independent, safe, supportive and confidential service. Also remember to make use of the GP Synergy wellbeing subsidy!
Information flows have dramatically increased recently which can make it hard to keep track of what is going on. We will try to summarise a few points. Firstly, many of you will be aware of the changes to the RACGP OSCE examinations which have now become the Remote Clinical Exam (RCE). The first set of RCE exams are due to be sat at the end of October over three to four sessions, so make sure you enroll by Monday 20 July. GP Synergy is currently working hard to put together some resources to help registars prepare for this new exam format. The ACRRM MCQ is due to be sat at the start of September and enrolments are still open.
For those registrars starting their second term, we encourage you to go to the General Practice Registrar Australia (GPRA) website to ensure that your National Terms and Conditions of Employment of Registrar (NTCER) requirements are being met. It should also be mentioned that GPRA is in the process of addressing concerns for registrars regarding key issues, particularly around the low base rate of pay, lack of portable entitlements and access to parental and study leave. Hopefully this is something that will be actioned in the future.
RLOs are here to support you with any questions or concerns, and help advocate for fellow registrars, so feel free to get in touch if you need any support.
Dr Hugh Stump | Registrar Liason Officer Western NSW
Dr Amy Daly | Registrar Liason Officer Murrumbidgee & ACT
We have been circulating information concerning the impact of COVID-19 on the training program. This includes FAQs and changes to our face-to-face education program.
Rural generalist applications
Are you interested in pursuing a career as a rural GP who provides primary care in a community setting as well as advanced services and/or procedural skills within a rural hospital? Applications for the NSW Rural Generalist Medical Training Program (RGTP) open 23 July.
Wellbeing support for registrars
We recognise that this continues to be a difficult time for registrars who have been negatively impacted by COVID-19. If you have not yet done so, we encourage you to access the additional wellbeing supports that are currently available including:
- Health and wellbeing reimbursement that can now be claimed using the simplified GPRime claims process. Wellbeing claims can be lodged until 31 July 2020.
- Confidential counselling sessions GP Synergy registrars can access two confidential counselling sessions through Relationships Australia in addition to counselling services provided through your college.
Please don’t hesitate to contact your medical educator if you require any assistance.
Are you interested in being a registrar representative for the GP Synergy Education Committee?
The Education Committee is a GP Synergy Board subcommittee with representation from GP Synergy’s Board, ACRRM, RACGP, and GP Synergy’s senior medical education and research teams. It reports directly to the GP Synergy Board.
GP Synergy is seeking to add registrar membership to this governance committee with ACRRM and RACGP registrar representatives.
2020 Rural video competition
Entries for the 2020 GP Synergy rural GP video competition will open in August. If you've got an idea for a video that will help inspire the next generation of doctors to become rural GPs in NSW, start shooting now!
Medicare provider number reminder
The deadline for Medicare provider number paperwork to be submitted has now past.
Ensure that once you have received your Medicare provider number, you check your letter to confirm you have been issued with a provider number with full billing rights before you commence billing patients.
Registrars with refer and request rights will only be able to refer patients and request investigations, until a provider number with full billing rights is received.
2020.2 term dates:
3 Aug 2020 – 31 Jan 2021
Congratulations to Dr Lillian Zhang who has been awarded the RACGP Tony Buhagiar Memorial Medal for the GP candidate in the NSW & ACT Faculty who passed all three examinations on their first attempt within the last three years and achieved the highest OSCE score.
Does our education program work? Can we tell if our teaching makes a difference?
Evidence from the GP Synergy NSW & ACT Research and Evaluation Unit – each month we present findings from our work that may be of interest to registrars and their supervisors.
In our vocational specialist GP training program, education and teaching have multiple aims. We aim to influence registrars’ knowledge, skills, attitudes, professionalism, and their clinical practice (and, ultimately, patient well-being). Researching directly whether we affect patient well-being is exceedingly difficult. But we can evaluate and research outcomes of our education at these other levels.
Of these, establishing effects on actual clinical practice is the most challenging (and often the most important). Educational activities are often ‘complex interventions’. And clinical practice is complex and highly contextual. We have, however, attempted to assess the impact on clinical practice of a number of educational innovations in general practice vocational training.
An example is a program of work around rational prescribing of antibiotics for non-pneumonia respiratory tract infections - identified by the WHO as a major global health threat. Our initial work had identified a problem. From ReCEnT data we saw that registrars seemed to prescribe antibiotics somewhat less than established GPs, but still well in excess of international benchmarks. Qualitative work we did with a North Coast academic registrar gave us a great deal of insight into the context of this prescribing. Together with further examination of the ReCEnT data, review of the international literature in the area, and infectious disease content-expert input, we constructed an educational package including an online module, presentations to registrars and supervisors, and a structured outline for a one-on-one registrar-supervisor teaching session. We delivered this package in 2014 and 2015.
We evaluated this educational package with three modalities. We measured before-and-after questionnaire responses (in a study design without controls) to clinical ‘vignettes’ (i.e. ‘intended practice’, or knowledge and attitudes); we made comparisons including pre- and post-education ReCEnT data, and whether the registrars’ Regional Training Provider delivered the education or not (i.e. ‘actual clinical practice’); and conducted a post-education qualitative study of registrars and supervisors.
For ‘intended’ vignette-based prescribing we found statistically significant absolute reductions of 12-24% in registrars intended antibiotic prescribing for the sore throat, otitis media, and two of three acute bronchitis vignettes . For ‘actual prescribing’, there was a significant 16% absolute reduction in antibiotic prescribing for acute bronchitis . This reduction compares favourably with results from other educational interventions for antibiotic prescribing internationally. An important finding of the qualitative study was of an absence of registrar-supervisor conflicts concerning antibiotic prescribing, but most participants identified conflicts within the GP practice or with specialists .
Our conclusion was that RTPs’ (now RTOs) education can positively influence registrars’ clinical practice. We also feel that there is suggestive evidence that actively involving supervisors in this education is valuable. It also seems likely that, for many clinical behaviours, involvement of the whole teaching practice in the education is desirable.
- Magin P, Morgan S, Tapley A, Davis J, McArthur L, Henderson K, Mulquiney K, Dallas A, Davey A, Scott J, van Driel M. Reducing general practice trainees’ antibiotic prescribing for respiratory tract infections: an evaluation of a combined face-to-face workshop and on-line educational intervention. 2016. Education for Primary Care. 27(2):98-105
- Magin P, Tapley A, Morgan S, Davis J, McElduff P, Yardley L, Henderson K, Dallas A, McArthur L, Mulquiney K, Davey A, Little P, Spike N, van Driel M. Reducing early-career general practitioners' antibiotic prescribing for respiratory tract infections: a pragmatic prospective non-randomised controlled trial. 2018. Family Practice. 35(1); 53-60.
- Deckx L, Anthierens S, Magin P, Morgan S, McArthur L, Yardley L, Dallas A, Mulquiney K, Little P, van Driel M. Focus on early-career GPs: qualitative evaluation of a multi-faceted educational intervention to improve antibiotic prescribing. 2018. Family Practice 35(1); 99-104.
If you would like further information, please contact Parker Magin.
My Health Record Study
You are invited to participate in an interactive educational series that will be conducted by Medcast and evaluated by the University of Wollongong on behalf of the funding body, the Australian Digital Health Agency. The sessions are designed to support best-practice prescribing, pathology and diagnostic imaging ordering utilising My Health Record.
2020.1 key training dates
Stay on top of the key training dates for the 2020.1 term.