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RACGP Standards for general practice training (4th edition)

A guide to using the Standards

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Table of contents

Last revised: 10 Apr 2024

A guide to using the standards

Structure overview

The standards are written as a series of outcomes. Outcomes-based standards are more adaptable as they describe the required endpoint rather than the means of getting there. This is important as it allows flexibility in the training program. The range of contexts in which training occurs, the rapidly changing landscape of technology and the potential for environmental factors to impact training, as demonstrated by the COVID-19 pandemic, are factors that illustrate the need for flexibility. Further, flexibility encourages innovation in program delivery leading to improvement through change.

Figure 4. Interrelationship of the Standards.

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Each of these standards is formatted the same for consistency and include:

Standard – a statement of the level of quality or attainment to be expected. The accompanying rationale explains why the standard is important.
Rationale - summarises the content of the standard and the relevant evidence
Outcome - the end result, or statement that contributes to overall achievement of the standard.
Criteria – contribute to attainment of the outcome.
Guidance - provides further background and suggestions to assist in how the criteria and outcomes may be met.
Related policies and resources - provides links to relevant RACGP information.
Suggested evidence – a list of possible sources of evidence to demonstrate or measure how the standard has been met.

Use of ‘could’, 'should’ and ‘must’:

The Standards have been written using carefully considered language. Although largely outcomes-focused, there are some inputs that are still considered essential and are therefore mandated at program level. Where they apply in the guidance and criteria sections, the words ‘could’, ‘should’ and ‘must’ have been used deliberately.

‘Could’ is used to indicate something that is optional and a suggestion.
‘Should’ is used to indicate something that is optional but recommended.
‘Must’ is used to indicate something that is mandatory.

Table of Standards, Outcomes and Criteria

A downloadable version of the table of standards, outcomes and criteria is available here.

Standard 1 - The registrar is suitable and ready to commence in a general practice training program
Outcome	Criteria
1.1 Training program details are clear, transparent, and accessible	1.1.1 Details about the training program are publicly available
	1.1.2 Requirements for eligibility into the training program, including any exemptions, are clearly communicated to the candidate prior to selection

1.2 The process for selection ensures that selected candidates are supported, eligible and have the competencies required to commence training	1.2.1 The selection process is in accordance with national and international standards for post-graduate training
	1.2.2 The selection process is clear, transparent and accessible
	1.2.3 Selection is based on the expected RACGP competencies at the point of commencement including the professional attributes expected of a doctor entering general practice training
	1.2.4 Selection supports access for Aboriginal and Torres Strait Islander doctors to train in general practice
	1.2.5 Selection supports access for candidates to train in areas of workforce need

1.3 The registrar is ready to commence training	1.3.1 The registrar demonstrates eligibility to commence training
	1.3.2 Registrar learning activities and the teaching strategies used are appropriate to registrar needs, stage of training and training context
	1.3.3 Assessment of the registrar’s competence and suitability for commencing training informs the selected registrar’s training plans
Standard 2 - The clinical experience supports the development of the registrar
Outcome	Criteria
2.1 The registrar experiences the breadth and depth of Australian general practice	2.1.1 The registrar accesses a broad range of relevant experiences defined by the RACGP Curriculum and syllabus for Australian general practice
	2.1.2 The registrar is exposed to a range of different practice models
	2.1.3 The registrar has fair and equitable access to training sites
	2.1.4 The registrar participates fully in the operations and scope of the practice in which they are located

2.2 The registrar undertakes supervised clinical practice in accredited training sites that provide a high-quality training environment	2.2.1 Training sites are accredited clinically and for training by the appropriate agency
	2.2.2 Supervisors are suitably qualified for their role
	2.2.3 Training sites and supervisors adhere to the RACGP training standards
	2.2.4 Training sites value learners, supervisors and educators
	2.2.5 Training sites are adequately resourced
	2.2.6 Training sites and supervisors provide best practice clinical care
	2.2.7 Supervisors undertake professional development relevant to their role
	2.2.8 The needs of various learners within the training site are appropriately managed

2.3 The training needs of the registrar are supported by their training sites	2.3.1 The registrar receives orientation to the training site
	2.3.2 An assessment of competence occurs at commencement in each training site
	2.3.3 The registrar is always supervised during training using a model of supervision that is developed and matched to the registrar’s assessed competency
	2.3.4 There is a process for developing, reviewing and adjusting the model of supervision appropriate to the needs of the registrar in the context of the practice
	2.3.5 The registrar is able to ask for and receive timely assistance in all clinical situations
	2.3.6 Workload is appropriate to stage of training, the context and the competency of the registrar
	2.3.7 Policies and procedures are in place that address patient and registrar safety in the practice
	2.3.8 Practices meet their legislative requirements for the employment of the registrar
	2.3.9 Registrar stress and fatigue is identified, acknowledged and addressed
	2.3.10 Actual and potential conflicts of interest are identified and managed
	2.3.11 Adverse events (including critical incidents) are identified and managed

2.4 Practices and supervisors are supported to deliver training	2.4.1 Supervisors are provided professional development opportunities relevant to their role
	2.4.2 Supervisors and the practice receive regular feedback about the training site
	2.4.3 Monitoring and accreditation processes ensure quality assurance and are fair, transparent and consistent
	2.4.4. Accreditation processes encourage quality improvement
	2.4.5 Aboriginal and Torres Strait Islander cultural advisors and/or medical educators are involved in accreditation process where relevant
	2.4.6 Practices and supervisors are supported when concerns arise
	2.4.7 Processes for the placing of conditions on practices and/or supervisors or for deaccreditation are clear and transparent
	2.4.8 There are documented reconsideration and appeals processes available for practices and supervisors
Standard 3 - The education program maximises registrar learning
Outcome	Criteria
3.1 An education program relevant to Australian general practice is delivered	3.1.1 The education program is clearly mapped against the RACGP Curriculum and syllabus for Australian general practice
	3.1.2 Priority areas are embedded in the education program
	3.1.3 Aboriginal and Torres Strait Islander educational imperatives are met

3.2 The education program is current and based on educational best practice	3.2.1 Registrar learning activities and the teaching strategies used are appropriate to registrar needs, stage of training and training context
	3.2.2 A variety of teaching, learning and assessment methods are used to achieve the intended educational outcomes
	3.2.3 The registrar has access to regular, structured and planned teaching time
	3.2.4 The educational program is planned, delivered, monitored and evaluated by an education team that is skilled, experienced and adequately supported

3.3 The education program prioritises safety	3.3.1 The learning environment protects the registrar’s physical, psychological and cultural safety
3.3 The education program prioritises safety	3.3.2 The learning environment protects patient safety

3.4 The registrar develops research literacy skills	3.4.1 The program includes education about research relevant to general practice
3.4 The registrar develops research literacy skills	3.4.2 Registrars have opportunities to participate in research during training
Standard 4 - A program of assessment promotes, records and informs registrar performance
Outcome	Criteria
4.1 The approach to assessment is clearly defined	4.1.1 Assessment policies and procedures are readily available
	4.1.2 Registrars are informed of the assessment and progression requirements of the program
	4.1.3 Assessors are competent in assessment
	4.1.4 Assessors identify and manage conflicts of interest

4.2 Assessment methods are fit for purpose	4.2.1 The program of assessment is blueprinted to the RACGP curriculum and syllabus for Australian general practice and the Progressive capability profile of the general practitioner
	4.2.2 The assessment methods are appropriate to the stage and context of the training
	4.2.3 Assessment must focus on performance in practice
	4.2.4 Criteria against which the registrar is assessed are clear, measurable, equitable and transparent
	4.2.5 The program is regularly reviewed

4.3 The program of assessment is used to improve performance	4.3.1 The registrar’s progress is documented, monitored, regularly assessed and readily available to the registrar and the training program
	4.3.2 Self-reflection is promoted, and assessment of progress is used to plan the registrar’s ongoing training
	4.3.3 Registrars receive timely, constructive feedback which is used to improve performance
	4.3.4 The registrar has access to exam support

4.4 Underperforming registrars are identified, supported, and managed	4.4.1 Underperformance or other concerns are identified and managed early
	4.4.2 Processes are in place to support registrars in remediating underperformance
	4.4.3 Educational interventions to improve performance are clear
	4.4.4 The outcomes of educational interventions are reviewed regularly
	4.4.5 Relevant regulators, the RACGP and other relevant organisations and individuals are advised where safety is of concern
Standard 5 - The training program is supported by robust governance
Outcome	Criteria
5.1 The governance structure is appropriate, transparent and accessible	5.1.1 There is a documented model of training that provides direction for the program
	5.1.2 The training model is reviewed and updated in relation to evolving needs and best practice
	5.1.3 The governance structure ensures there are mechanisms in place for managing program authority, accountability and responsibility for decision making

5.2 Stakeholders are engaged in the development and delivery of the training program	5.2.1 Stakeholders participate in the planning process
	5.2.2 Stakeholders contribute to the delivery of the training program
	5.2.3 Effective communication occurs to facilitate effective program delivery

5.3 Systems and processes support the training program and the registrar	5.3.1 The systems and processes used to keep records, deliver training and monitor the progress of the registrar are up-to-date and secure
	5.3.2 There are policies and procedures for the identification, mitigation and management of risks
	5.3.3 The quality management system enhances stakeholder satisfaction and is regularly reviewed
	5.3.4 Reporting requirements are complied with

5.4 A program of evaluation is embedded and informs program improvement	5.4.1 There is a formal review and quality improvement process to which stakeholders contribute
	5.4.2 Data is collected and used to improve education program quality
	5.4.3 A culture of feedback is established
	5.4.4 Quality improvements are identified and implemented as a result of the review process
	5.4.5 Outcomes of evaluation are communicated to those involved in the program
Standard 6 – The training program is accountable to the Australian community
Outcome	Criteria
6.1 The context and needs of communities are addressed	6.1.1 Training design and delivery is appropriate to the context in which it is delivered
	6.1.2 Areas of need are identified and addressed.
	6.1.3 A clearly stated approach to the recruitment of suitable training sites is communicated

6.2 The program works collaboratively with Aboriginal and Torres Strait Islander peoples to support the health of their people and communities	6.2.1 Aboriginal and Torres Strait Islander peoples are involved in the design, delivery, assessment and evaluation of education related to holistic, person-centred healthcare for Aboriginal and Torres Strait Islander peoples
	6.2.2 Registrars, supervisors and practice staff participate in cultural safety training
	6.2.3 Registrars have access to Aboriginal and Torres Strait Islander cultural educators and mentors
	6.2.4 The program has measures in place to increase the number of Aboriginal and Torres Strait Islander GPs
Standard 7 - The training program provides pastoral support
Outcome	Criteria
7.1 The program supports the registrar and problems are effectively addressed	7.1.1 The registrar is able to ask for and receive timely assistance about their training program
	7.1.2 Registrar concerns regarding their program are appropriately addressed
	7.1.3 There are documented dispute, reconsideration and appeals policies and processes in place that are transparent, accessible and follow best practice guidelines
	7.1.4 Discrimination (including racism), bullying and harassment is addressed in policies of the training program and within the training site with processes for reporting and addressing issues clearly available
	7.1.5 Registrars are treated equitably with policies and processes related to diversity, equity and inclusion
	7.1.6 Adverse events (including critical incidents) are appropriately managed and resolved
	7.1.7 Support is in place to ensure registrar wellbeing
	7.1.8 Registrars from vulnerable populations are supported
	7.1.9 Registrars have access to career advice
	7.1.10 The training program structure accommodates flexible working and study arrangements

7.2 Staff delivering the program are supported	7.2.1 Cultural safety for staff is maintained
	7.2.2 There are transparent and documented policies and procedures including those related to a safe working environment
	7.2.3 Equity and access are embedded in policies and procedures
	7.2.4 Staff roles and responsibilities are clearly defined
	7.2.5 Staff receive induction
	7.2.6 Staff have access to professional development to support their role
	7.2.7 Support services are available for staff under stress
Standard 8 - The registrar completes the training program and is eligible to apply for Fellowship
Outcome	Criteria
8.1 The registrar is competent to commence working as an unsupervised specialist GP in Australia having met RACGP requirements for Fellowship	8.1.1 The registrar has demonstrated satisfactory completion of the educational and training requirements of the training program
	8.1.2 The registrar has successfully completed all assessments
	8.1.3 The registrar has demonstrated the professional behaviour expected by the RACGP and the public of a GP practising in Australia

How can I use the standards?

The RACGP has developed the fourth edition of the Standards for general practice training (the Standards) to set the requirements for training programs to deliver safe, high-quality training that meets the program outcomes of enabling registrars to be fully prepared and competent to meet the requirements of RACGP Fellowship.

The Standards also support general practice training programs to identify and address any gaps in their systems and processes, providing opportunities for improvement.

Why does the RACGP have standards for Training as well as standards for Practices?

The RACGP Standards for general practices are to ensure the quality and safety of health services to protect patients from harm. There are additional considerations that practices and GPs as supervisors need in order to provide a quality training environment for registrars. Practices wishing to become training sites need both practice and training site accreditation.

The Standards for training also apply to the operation of the training program as well as training sites and supervisors.

Not all training programs are the same. How can the Standards apply to different training programs?

The Standards are written as outcomes. The processes by which the training programs achieve these outcomes are flexible and can be defined by the individual programs. For example, the Standards require that a training program has a robust governance structure where stakeholders are included, but they do not dictate how this is to be done. That is for the program to determine.

There are several variables that contribute to how a training program is developed and delivered, these may include:

Where training occurs - training may occur across metropolitan, rural, or remote locations, or a blend of these.
Participants – registrars should select a program that best suits their individual circumstances, including levels of experience, different learning needs and ways of learning.
Level of available resources and funding.

Consider the following examples:

Training program A delivers training to a group of registrars in remote parts of Australia.
Training program B delivers training to a group of registrars in metropolitan areas of Australia.

Example 1

Criterion 2.1.2: The registrar is exposed to a range of different practice models.

Training program A meets this by including information about different practice models in their education program and arranging visits to other practices.
Training program B meets this by having registrars work at different practices during their training.

Example 2

Criterion 4.3.4: The registrar has access to exam support.

Training program A provides this in the form of online learning
Training program B provides in-person exam preparation sessions

In both examples, the standards describe what should be provided but not how this is done. The training program determines how it meets the standard by setting its own inputs and processes. Each program should define its method of delivery and clearly document this in its handbooks and guidance documents to assist participants to understand and meet their requirements.

Who needs to use the Standards?

The Standards apply to all training programs, so everyone involved in general practice training should be aware of the Standards.

Some examples of applications of the Standards include:

use by the program to support accreditation decisions for practices or supervisors.
forming the basis for the training program policies and processes, ensuring consistency of outcomes across training programs.
Use in the evaluation of programs, training sites and educational experiences, for example, in developing surveys for collecting feedback from those involved in the program.

The Standards can be used by accrediting bodies as a benchmark for quality. The RACGP may use the Standards to monitor, evaluate and accredit other general practice training programs, such as RVTS. The RACGP Standards for general practice training align to the AMC Standards which helps the RACGP meet regulatory requirements for delivering GP education and training.

How do the Standards apply to me?

Registrars

If you are a registrar, the Standards have been developed to reflect your journey from commencement to completion of your Fellowship training. The Standards outline what you can expect from your program and what is expected of you, your training site and your supervisor.

The tables below summarise the expectations and responsibilities and the criteria they relate to. Please refer to training program handbooks for specific details.

TABLE 1. Registrars - what can I expect from my training program.pdf

TABLE 2. Registrars - what are my responsibilities in the training program .pdf

Supervisors and Training sites

If you are a supervisor the Standards outline your role in the training program, and the support you can expect from the training program and training site. Standards 2 and 3 detail what is expected of a training site and supervisor while the guidance provides suggestions for supervisors and training sites that can be used to ensure a quality training experience which will be attractive to registrars.

The Standards will be used to accredit training sites and supervisors. At the time of accreditation, training sites and supervisors will be measured against the outcomes in the Standards. Ongoing evaluation and monitoring are an important part of making sure training sites and supervisors continue to meet the expectations set by the Standards. For training sites and supervisors, the process of accreditation or reaccreditation provides an opportunity to review current policies and processes and to look for ways to improve. The use of the words ‘should’ and ‘could’ within the guidance sections of each Standard provide suggestions for quality improvement.

Example:

Criterion 2.3.6: ‘Workload is appropriate to stage of training, the context and the competency of the registrar’

The guidance section of Outcome 2.3 includes suggestions about how a supervisor can ensure that the registrar sees a wide range of patient ages and conditions. Not all of these must be implemented but using these suggestions can help improve the quality of the training experience.

The tables below summarise the expectations and responsibilities for training sites and supervisors:

TABLE 3. Supervisors - what can I expect from the training program .pdf

TABLE 4. Supervisors - what are my responsibilitites in the training program.pdf

TABLE 5. Training sites - what can I expect from the training program.pdf

TABLE 6. Training sites - what are my responsibilities in the training program.pdf

Training programs

If your role is within the training program, how you use the Standards will depend on your role. You and your team have a responsibility to develop, deliver and monitor the program to ensure it continues to meet expectations and deliver the outcomes set out in the Standards.

Each standard includes examples of suggested evidence and documentation to help training programs develop specific guidance for participants, supervisors, and training sites. These lists are suggestions only; not all forms of evidence need to be provided and other forms of evidence may be used. Each program will develop and document the appropriate processes to show how outcomes will be achieved. The program is responsible for communicating information to participants.

A summary of the essential requirements for training programs, i.e. what ‘must’ be done, is available below.

TABLE 7. Training program requirements.pdf

All staff working in the program can expect appropriate support (see Outcome 7.2).

Some of the teams who will be involved in program delivery include:

Policies and processes

Program policies need to align with the Standards. The policies provide the high-level principles and requirements, while the processes are program specific information in the application of the policy.

Training site and supervisor accreditation teams

The Standards provide the basis for developing processes and documentation to accredit and monitor training sites and supervisors. Each standard provides a list of suggested evidence which might be collected while monitoring accreditation.

Assessment and selection

The requirements of an assessment program are detailed in Standard 4.

Educational program development and delivery

The details of the educational program are outlined in Standard 3.

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