Appendix D. Remediation Agreement (pro forma)

(The following list should be edited accordingly [items removed/added] to reflect the registrar’s specific and individual learning needs.)

Communication skills and the patient–doctor relationship

• Developing good listening and language skills appropriate to the patient
• Engendering confidence and trust
• Responding appropriately to patient cues
• Confirming the patient’s understanding of the problem, the management, advice given and follow-up

Applied professional knowledge and skills

• Competently managing common problems
• Recognising and managing the significantly ill patient
• Negotiating, prioritising and implementing structured and individually tailored management plans and agreeing on respective responsibilities and limits
Prescribing safely and cost-effectively from an informed knowledge base
• Making valid and timely decisions about referral and follow-up
•  

Population health and the context of general practice

• Eliciting and taking into account the patient’s background (sociopolitical and cultural), relationships with family and significant others
• Understanding and responding to the special needs of the practice population
• Addressing public health concerns
• Working as a team member and coordinating patient care
• Billing appropriately

Professional and ethical role

• Having responsibility for the optimal care of patients (respecting patient–doctor boundaries, confidentiality, recognising own limitations, appropriate reporting and follow-up, advocating for the patient)
• Developing the capacity for self-awareness and reflection
• Developing professional networks for personal and clinical support
• Developing time management and coping skills to maintain care of self and family
• Maintaining professional standards
• Adhering to professional codes of conduct

Organisational and legal dimensions

• Using personal, organisational and time management skills in practice
• Using and evaluating practice management skills relating to staff management, teamwork, office policies and procedures
• Incorporating medico-legal knowledge and responsibilities relating to certification and prescribing

The activities for addressing these identified needs are [state the specific intervention measures, including monitoring process]:

• a general practice term of [insert number of weeks] duration
• participation in [list the specific educational activities in accordance with AGPT and RACGP requirements]
• [number of] external clinical teaching visits (ECTVs) during the term [either the standard number or more
  as deemed necessary for monitoring]
• regular [weekly, fortnightly etc; as deemed necessary] placement reviews encompassing a review of personal, clinical, team and professional performance, assessment of the practice environment, an evaluation of teaching sessions and review of patient consultations
• regular contact with a medical educator to monitor progress and provide ongoing support/education
• regular contact with the remediation officer to monitor progress and provide ongoing support.

The Remediation Plan supports registrars identified by their RTO as having remediable clinical skills deficiencies. The Remediation Plan aims to address those deficiencies by providing targeted learning and support.

Only AGPT Program registrars pursuing Fellowship of the RACGP (FRACGP) are entitled to participate in this Remediation Plan. As part of this agreement you will be assigned a supervisor, medical educator and an RTO officer. These people will assist you to develop a Learning Plan addressing your identified learning needs. To complete the Remediation Plan, you must satisfy your individual Learning Plan formulated to your specific learning needs.

Upon commencement of the Remediation Plan, your training time will be suspended to support the remediation. Remediation decisions may be appealable. Refer to your RTO’s appeals policy.

To satisfy your agreement obligations you must:

• complete the required Remediation Plan
• complete the required ECTVs
• actively participate in all educational activities and demonstrate adequate progression
• keep a log of teaching sessions, learning activities and personal progress against your objectives
• regularly review your own progress
• work with your supervisor and medical educator to satisfy your objectives
• comply with all applicable policies, requirements and conditions from your RTO
• demonstrate satisfactory improvement in the areas identified in the Learning Plan
• exercise the degree of professionalism, skill, care and diligence expected of an Australian GP.

It is expected you will do all things necessary to complete all educational activities and satisfy the requirements of your targeted learning areas within the remedial term.

Your RTO will provide you with a supervisor during your Remediation Plan. Your supervisor will:

• support you to implement your Learning Plan
• regularly review your progress in meeting your objectives
• regularly report your progress to your RTO officer
• keep records of all your meetings and submit them regularly to your RTO officer
• regularly discuss and provide feedback to you, including on whether your objectives are being or have been met
• provide a written report to your RTO officer outlining whether your objectives have been met at the completion of the Remediation Plan.

Medical educator

Your RTO will provide you with a medical educator during your Remediation Plan. Your medical educator will:

• support you in implementing your Learning Plan
• regularly review your progress in meeting your objectives
• regularly discuss with you your progress in meeting your objectives
• regularly report on your progress to your RTO officer
• keep records of all your meetings and submit them regularly to your RTO officer
• provide regular feedback to you on whether your objectives are being met, or have been met at the completion of the Remediation Plan.

RTO officer

Your RTO will provide you with an RTO officer during your Remediation Plan. Your medical educator will:

• monitor your progress in attaining objectives
• maintain regular contact with you, your supervisor and your medical educator
• review all documentation, including that relating to your ECTVs, the Learning Plan and other reports
• collate all reports in relation to your progress provided by the remedial medical educator and the remedial supervisor
• regularly report on your progress to the RACGP
• make a decision regarding the final outcome of your Remediation Plan
• provide feedback to you on whether objectives have been met at the completion of the Remediation Plan
• report the final outcome of your Remediation Plan to the RACGP.

Upon completion of the Remediation Plan, the following outcomes may occur.

• If the remediation officer in consultation with the director of training consider you have satisfied your obligations in this agreement, they will recommend to the RTO that you may resume training, with your training time extended by the duration of the Remediation Plan.
• If the remediation officer in consultation with the director of training consider you have not satisfied your obligations in this agreement, they will recommend to the RTO that you be withdrawn from the AGPT Program.

 Resignation

You may resign from the Remediation Plan. If you do so, you will also resign from the AGPT Program. To resign, provide your RTO with written notice of such. Your resignation will be effective from your RTO’s acceptance of your letter. This agreement will simultaneously end.

Removal

The RACGP and your RTO offer the Remediation Plan in good faith, to assist and support medical practitioners.

However, if this good faith is not reciprocated, the RTO may determine to remove you from the Remediation Plan. Such determinations will not be made unreasonably.

Your RTO will provide you with a removal notice. You will be removed from the Remediation Plan from the date of your RTO’s removal notice. You will also be removed from the AGPT Program. This agreement will simultaneously end.

In addition, the RTO may remove you for either of the following reasons:

• no adequate progression demonstrated
• pursuant to the RACGP’s Fit and Proper Fellow Policy.

In this agreement:

• AGPT Program means the Australian General Practice Training Program.
• ECTVs means external clinical teaching visits.
• FRACGP means Fellowship of the RACGP.
• Learning Plan means the plan developed between yourself and your RTO, which will be annexed to this document and form part of your Remediation Plan.
• Objectives means your objectives as stipulated in the Learning Plan.
• Registrar means you, being a medical practitioner pursuing FRACGP.
• RTO means your Regional Training Organisation as stipulated in the Remediation Agreement.
• RTO officer means the RTO delegate with decision-making authority concerning your Remediation Plan.