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RACGP Standards for general practice training (4th edition)

Standard 1. Commencement

Last revised: 10 Apr 2024

Standard 1 | The registrar is suitable and ready to commence in a general practice training program
 

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Commencement into a training program requires: 

  • Candidates to be fully informed about the program in order to make an informed decision about their career choice and application for training.    

  • An entry process which aims to select candidates based on eligibility and suitability for commencement in general practice training in that they are likely to be successful in achieving Fellowship and become competent GPs.  

Selection processes may vary between programs, but the overall principles are consistent. These include that: 

  • Assessment is valid, reliable, merit-based and free from discrimination or bias. 

  • Processes are regularly reviewed and evaluated to ensure they remain valid, reliable and equitable that processes are reviewed to ensure biases are addressed.   

Each registrar brings their own professional and life experiences. This includes their experiences in undergraduate training, previous work as a medical practitioner in Australia or overseas, or transferable skills from a different career. These different life experiences mean each registrar begins their program at different levels of competence.   

The training program must ensure that a registrar has essential competencies to commence in general practice. The Progressive capability profile of the general practitioner describes a set of competencies that the doctor is expected to be able to demonstrate to commence in general practice at the Entry milestone. These include clinical skills such as the ability to identify and manage red flags and emergencies, as well as professional skills and behaviours such as the ability to self-reflect, communicate clearly and respectfully with others, and cultural awareness. There is good evidence1 that prior unprofessional behaviour correlates with future unprofessional behaviour and consequent disciplinary action by medical boards. Essential competencies can also relate to breadth of experience and exposure to patient populations with specific attributes.   

There is some evidence that selection assessments can predict later performance in exams.2,3 Performance in the selection assessments, and details from selection such as previous experience, provide a baseline for registrars, supervisors and medical educators. The baseline assists in planning an individual learning program and is used in future assessments to determine progression through the training.     

Outcome 1.1 Training program details are clear, transparent, and accessible

Criteria
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 

Guidance  

Information about a program may be available in a variety of formats but must include:   

  • Time required to complete the program.  
  • Costs of the program.  
  • Training opportunities including flexibility in working arrangements, transfers and opportunities to extend skills. This may include catering to specific circumstances e.g. cultural needs.     
  • Career and program supports, including case management, available within the program for specific groups, e.g., registrars working in rural areas, Aboriginal and Torres Strait Islander registrars, international medical graduates, and registrars with additional needs.     
  • Any mandatory requirements within the program, e.g., training in rural, remote or outer metropolitan areas.   
  • Support for educational or professional concerns  
  • The selection process and the eligibility criteria for selection.  
  • Any prerequisites, such as the competencies and experience required to commence training at a general practice training site.  
  • Recognition of Prior Learning and Experience (RPLE) opportunities   
  • Pastoral and educational supports and mentorship available in the program.  
  • Educational program including mode of delivery  
  • Circumstances in which removal from the program may occur 

Outcome 1.2 The process for selection ensures that selected candidates are supported, eligible and have the competencies required to commence training

Criteria 

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

Guidance 

  • Candidates must be informed of the selection criteria, and the processes for selection, including those related to reconsiderations or appeals of decisions made.  
  • The selection process will include an assessment of both eligibility and capability. Eligibility is about having the required credentials and prior experience. Capability is about having the competencies required to commence RACGP training for Fellowship as detailed at the Entry milestone in the Progressive capability profile of the general practitioner. These competencies include knowledge, skills and attitudes. Professional attitudes are particularly important to assess.  
  • Candidates who identify as Aboriginal and Torres Strait Islander doctors or those who wish to train in an area of workforce need may be given particular consideration and support in the selection process. This is in line with the National Agreement on Closing the Gap4 and workforce initiatives. 

Outcome 1.3 The registrar is ready to commence training

Criteria 

1.3.1 The registrar demonstrates eligibility to commence training 

1.3.2 The registrar demonstrates achievement of the required competencies including the essential safety requirements, before commencing at a general practice training site   

1.3.3 Assessment of the registrar’s competence and suitability for commencing training informs the selected registrar’s training plans

Guidance 

  • Commencement of training requires the candidate to have met the eligibility and selection criteria of the program.  
  • Evidence of the competencies required must be documented and available to registrars and the program team. 

In some programs, where there is the option to complete further hospital training, selection may focus on eligibility and registrar ability to meet the baseline defined competencies before commencing in general practice. 

Where the training program requires the registrar to commence directly into a general practice, the registrar needs to meet the competencies described in the Entry milestone of the Progressive capability profile of the general practitioner, and the training program could provide details about how these would be met.  

Supporting documentation: 

  • Selection criteria   
  • Details of selection process (process map, work instruction etc.)   
  • Policies and procedures related to the selection process   
  • Outlines of information sessions or other communications that detail the selection process including web accessible information   
  • Information on mandatory requirements   
  • Outline of the training or support offered to interviewers/assessors including recognising bias 
  • Processes for assessing selection competencies   
  • Advice about and documentation of completion of BLS and ALS courses 
  • Handbooks 

This information is currently under development and will be made available for each training program ahead of implementation in 2025. 

  1. Papadakis, MA, Teherani A, Banach MA, Knettler TR, Rattner SL, Stern DT, Veloski JJ, Hodgson CS. Disciplinary Action by Medical Boards and Prior Behavior in Medical School. N Engl J Med 2005; 353:2673-2682. doi: 10.1056/NEJMsa052596.
  2. Heggarty P, Teague PA, Alele F, Adu M, Malau-Aduli BS. Role of formative assessment in predicting academic success among GP registrars: a retrospective longitudinal study. BMJ Open 2020 Nov 24;10(11):e040290. doi: 10.1136/bmjopen-2020-040290.
  3. Stewart R, Cooling N, Emblen G, Turnock A, Tapley A, Holliday E, Ball J, Juckel J, Magin P. Early predictors of summative assessment performance in general practice post-graduate training: A retrospective cohort study, Medical Teacher, 40:11, 1166-1174, doi: 10.1080/0142159X.2018.1470609
  4. Commonwealth of Australia. Department of the Prime Minister and Cabinet. National Agreement on Closing the Gap. 2020
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