COVID-19 information for GPs in training

Due to the ongoing situation in Australia regarding COVID-19, the Board of the Royal Australian College of General Practitioners (RACGP) has made the difficult decision to postpone the below Fellowship examinations:

2020.1 OSCE

Original Date 23 May 2020

Revised Date 8 November 2020 (Close of enrolments tentatively 6 September 2020)

2020.2 KFP/AKT

Original Date 17 and 18 July 2020

Revised Date September 2020 (Close of enrolments tentatively 15 May 2020)

2020.2 OSCE

Original Date 8 November 2020

Revised Date February 2021 (Close of enrolments tentatively 23 November 2020)

The RACGP will continue to monitor the COVID-19 situation and make future decisions on exams based on newest information. Protecting the health and safety of our members and the community is our paramount priority and we are acting to ensure we can minimise the risk of transmission as much as possible.

I have tried to enrol today and found that enrolment has been cut off, when can I enrol?

The RACGP has temporarily closed enrolments to facilitate the changes to the Fellowship exam calendar. Enrolments will reopen on 20 April 2020. For more details and the latest information, check the exam enrolment periods page.

I was enrolled in 2020.1 OSCE, what does the exam postponement mean for me?

Candidates who are currently enrolled in the May OSCE will be have their exam scheduled for 8 November. Candidates who are yet to enrol, and are eligible to sit the 8 November OSCE by the close of enrolments, can undertake the OSCE in November.

I was enrolled in 2020.2 AKT/KFP, what does the exam postponement mean for me?

Candidates enrolled in July AKT and KFP will undertake these exams in September, and their OSCE in February 2021 (date to be confirmed).

I have successfully passed one exam but not the others as yet. Will my exam pass validity period be extended?

Yes, this will be extended to match the delay in the next exam cycle.

How will the 6 attempt policy for Exams be impacted?

There will be no impact on the 3 year, six attempt exam limit (the Fellowship Exam Attempts Policy). Because the exams are keeping the same label, the 2020.1 OSCE will still be treated as part of the 20.1 semester, even though it's falling in the second half of the year. Same for the 20.2 OSCE, even though it's falling in 2021.

My 3 year candidacy expires in December 2020, will I still get to sit the OSCE in February 2021?

Because the exams are keeping the same label the February 2020.2 OSCE will still be treated as part of the 20.2 semester, even though it's falling in 2021.

My AKT and/or KFP results will expire before the rescheduled OSCE in November, will I need to repeat those exams?

Exams are linked to exam cycles, not dates. The 8 Nov OSCE is now part of the 2020.1 cycle so the postponement will have no effect if you sit on the new date.

Will I be refunded for exam prep workshops and mock exams or have the dates been postponed?

Exam preparation workshops and mock OSCEs will be refunded in full. New activities will be promoted in due course.

Can I get a refund for my exam enrolment?

If you wish to withdraw from an enrolled exam your refund will be issued under the normal process.

Payment in full is required 20 working days prior to the relevant exam, does that mean my OSCE fee is due 20 days prior to 8 November?

Payment in full will be required by 5pm AEST Friday 9 September 2020.

I was going to sit the exam before entering the PEP, can I still sit the November OSCE even if I start on the PEPE in July?

If you were eligible to sit the 2020.1, that eligibility will remain even if you have commenced PEP the OSCE is held in November.

The Practice Experience Program Entry Assessment (PEP EA) scheduled for 3 April 2020 has been cancelled

Protecting our members’ health and the health of the community is the RACGP’s top priority. We have made this decision in line with current Federal Government guidelines. The advice for social distancing and travel restrictions is changing daily and becoming increasingly stringent.

We understand that the timing of this assessment is extremely important to members, given its direct link to Practice Experience Program (PEP) eligibility and your ability obtain a PEP provider number. However, at this stage, we have no choice but to postpone your assessment.

We are asking those enrolled not to attend their scheduled PEP EA appointment on 3 April 2020.

We are working hard to minimise the impact of this delay on our members’ journeys to Fellowship. In the coming weeks, we will investigate alternative delivery arrangements for the PEP EA, including the potential to deliver a remote online assessment. As an interim step, your enrolment will be automatically deferred to the July PEP EA sitting. We are also working with the Department of Health and Medicare to minimise further disruptions.

My registration is conditional on achieving fellowship, how will the exams being postponed affect me?

We are working with the Medical Board of Australia on this and will provide more information as soon as we can.

What will happen if I run out of training time as a result of the exams being postponed?

Registrars affected by exam postponements will be able to access an additional extension term (6 months) if they would otherwise exceed their training cap. Please contact your RTO.

What will happen if my current practice doesn’t have a place for me as a result of this delay?

Your RTO will work with you to find an alternative training post. Once your contract at a practice expires, they have no contractual obligation to continue your employment as a registrar.

Will I still need to be employed under the NTCER and what will the implications be on my remuneration of having to extend my training?

You will still need to employed as a registrar until you Fellow. The NTCER stipulates minimum remuneration rates. You can negotiate higher rates with your practice.

I am on the rural stream but had planned to move to a metro area post fellowship, can I still go?

You will need to remain on the rural stream until you have completed your Fellowship.

Will AGPT and PEP activities continue uninterrupted?

Educational and assessment activities have been impacted by the evolving COVID19 situation. RACGP will continue to monitor the situation and provide regular updates about impacts on essential training activities. For information about postponement of RACGP examinations please see the relevant information on examinations.

Central RACGP PEP activities will continue (Learning Plan, Learning Units, etc) as these are online.
The delivery of RTO PEP and AGPT activities will be determined by individual RTOs. We are working together with the RTOs to ensure that GPiTs are not disadvantaged by any changes to activities.

What happens if a registrar misses an RTO education and training activity?

We are committed to ensuring that registrars are not unfairly disadvantaged by changes to education and training activities and that there are appropriate options available where traditional delivery formats are not feasible. Registrars are required to log 125 hours of education with their RTO over their training time as a requirement of Fellowship. Many of the RTOs have made the decision to stop face to face education activities but are offering non face to face options instead. This will still count towards your education requirement hours. RTOs are working on contingency plans for those workshops or activities that cannot be delivered in a non face to face manner.

Any mandatory activities missed are expected to be made up for in a manner that is at the discretion of the RTO. Given the extenuating circumstances, alternative ‘make-up’ activities may be offered. We encourage you to discuss this with your RTO.

My RTO has cancelled ECT visits, how will this affect my training requirements?

The RACGP and RTOs are working hard on developing alternative models that can be used for the external clinical teaching visits. You can expect to hear about what is being planned very soon.

My visa is conditional on achieving fellowship, how will the exams being postponed affect me?

We will provide a letter of support to the Department of Home Affairs if appropriate.

How do leave provisions apply to leave required for COVID-19?

When considering leave options we encourage all GPiT to have a look at the following resources:

• Individual contract with your workplace
• National Terms and Conditions for the Employment of Registrars (available on GPRA website)
• Fair Work Australia website – there is a specific resource entitled “Coronavirus and Australian Workplace Laws”

We have provided some common situations below.

I need time off work because I have respiratory infection symptoms OR have been tested for COVID-19 and need to self-isolate OR have been confirmed to have COVID-19 and need to self isolate

If symptoms are mild and you are well enough you may be able to perform teleconsultations from home and not require leave. Please see the below section on teleconsultations for more information.

In all of these situations, your reason for leave qualifies for sick leave. AGPT registrars are entitled to 5 days of paid sick leave and 2 weeks of paid annual leave (or full time equivalent) per six month term under the NTCER. It is important to know that the 5 days of paid sick leave per six months is available to both full time and part time registrars. Under the NTCER you do not need to wait to accrue sick leave and are entitled to an advance of 38 hours paid personal leave for each 6 month term upon commencement of the term. If you are working with the same employer for a full 12 months then you can negotiate to have the full advance of 76 hours paid personal leave allowable for the full 12 months upon commencement to help cover any period of sick leave required for COVID-19 reasons. Any leave above and beyond this, is at the discretion of the employer.

If you have run out of sick leave and annual leave (or alternatively are not wanting to use annual leave for this reason) then you will be eligible to access category 1 leave. Whilst category 1 leave does not contribute to training time it will not add to your training time caps. Please liaise with your training post and RTO to arrange any leave and complete any necessary leave forms.

For PEP participants, leave provisions are determined by their employment contract. Program length will not be affected.

My family member is sick with COVID19 and I need to care for them

Under the NTCER sick leave encompasses both personal leave and carers leave. The same answers to the question above will therefore apply.

I need time off work because I have been advised I need to self-quarantine as I am a close contact of a confirmed case or have recently returned from overseas

If you need to take time off work for self-quarantine reasons but are well in yourself then you may be able to undertake teleconsultations off site and not need any leave. Please see the section on teleconsultations below.

The Fair Work Act does not have specific rules in this situation. If you are not able to organise work from home arrangements with your practice then you need to negotiate with your employer the type of leave you are eligible for in this situation. This may include working from home, taking sick leave or taking annual leave.

As per above, if you have run out of sick leave and annual leave (or alternatively are not wanting to use annual leave for this reason) then you will be eligible to access category 1 leave. Whilst category 1 leave does not contribute to training time it will not add to your training time caps. Please liaise with your training post and RTO to arrange any leave and complete any necessary leave forms.

I need time off work because I (or a direct family member that I care for eg a child) have an underlying medical condition that puts me at increased risk of complications from COVID19 and I have been advised that I shouldn’t go to work as I need to minimise my risk of exposure

All GPiT are encouraged to discuss safe working conditions with their employer. If you fall into this category then it may be appropriate for your practice to put certain safeguards in place to reduce any potential exposure eg adequate triaging of patients, ensuring PPE, working from home arrangements or converting to teleconsultations onsite. We encourage you to discuss these options with your employer in the first instance and if a reasonable outcome can be achieved then no further action needs to be taken.

If you are unable to negotiate safe working conditions with your employer then you can apply for category 1 leave through your RTO with supporting documentation. We are aware that this situation could continue for an extended period of time and we do not want GPiT adversely impacted from either a remuneration or training time perspective. If on category 1 leave you are able to work in other roles (please see working on category 1 leave) and you may be able to negotiate a change of training placement that would enable a safer working option. We encourage you to discuss this option with your RTO as it will be dependent on your stage of training and placement options available.

Can GP trainees work while on category 1 leave?

We understand the financial strain that may result from needing time off work for COVID19 reasons especially if this time is an extended period. We are supportive of GPiT being able to work whilst on category 1 leave for this reason. Work that is consistent with the reason for category 1 leave is permissible with RTO approval and appropriate documentation. Any work undertaken while in isolation for COVID-19 reasons should not compromise that isolation.

Can GP trainees undertake teleconsultations?

With the escalating infection rates in Australia it is expected that a significant proportion of GP COVID-19 related advice and management for patients will be provided remotely through teleconsultation either by telephone or by videoconferencing. Some of this may be done remote to the site of the clinician’s main clinical practice, particularly if the clinician is under self-isolation but still able to consult. Trainees may be asked to contribute to the provision of teleconsultations. This may include when they are in self-isolation. The RACGP considers teleconsultations during the COVID-19 health crisis an appropriate clinical activity for GP trainees, provided that supervision arrangements commensurate with the normal supervision requirements are in place.

What are the supervision requirements for telehealth consultations?

Teleconsultations by GP trainees require supervision that is commensurate with normal supervision requirements. For teleconsultations, equivalence to onsite availability is considered the availability of the supervisor to be dialled into the registrar’s teleconsultation. Most teleconsultations platforms have the capacity for a third person to be dialled in.

Are there additional requirements for remotely delivered teleconsultations by GP trainees?

If a GP trainee is conducting teleconsultations off-site, the training post is responsible for ensuring that systems are in place for protecting patient privacy and for ensuring that the off-site worksite has the required workplace support, supervision and occupational safety provisions. Trainee engagement with remote supervision models requires agreement by the trainee who has the option to refuse. The RACGP expects all trainees to feel comfortable and well supported with any model used for remote supervision.
Training posts who wish to engage AGPT registrars in remotely delivered teleconsultations need to secure approval from their regional training organisation (RTO). RTOs are required to have a documented process for approving, managing and monitoring remotely delivered teleconsultations by registrars that is consistent with the guidelines detailed above. RTOs do not require prospective approval by RACGP for their chosen model to achieve this.

Can GP trainees in self-isolation continue to work through teleconsulting?

If the GP trainee is medically well enough, they may continue to work by teleconsulting as long as the above guidelines are adhered to. For AGPT registrars. Approval is required from the trainee’s RTO.

What happens if a supervisor has to take time off from work due to COVID19 related issues?

If an AGPT supervisor self-isolates, the supervisor or practice should inform the relevant RTO as soon as possible and ensure that any registrars under their supervision continue to receive the required supervision. If the practice has not done this then please speak with your practice or contact your RTO directly. All registrars continuing to train are required to receive supervision to the current standards with supervision for telephone and telehealth consulting detailed above. Supervision may be provided by an alternative Fellowed GP at the practice. Alternatively, if the supervisor is well enough to provide off-site supervision then this may also be an option depending on the registrar’s stage of training and competency. Any model that involves remote supervision needs the agreement of the registrar involved. The RACGP expects all trainees to feel comfortable and well supported with any model used for remote supervision.

JCU GP has made its telehealth resources for GP training open access. The resources include an excellent guide, supervision plan template and links to articles and webinars.

The Medical Board of Australia has Guidelines for Technology-based patient consultations. Further information about the guidelines is available here.