Introduction

General practice is a broad and complex discipline and requires a wide range of skills and knowledge. Registrars come to GP training with a varied skillset which is unique to each one of them. While many registrars will gain the required skills and knowledge during the standard training program, some registrars may require extra assistance and educational interventions to achieve the required level of competency to meet the requirements of fellowship for independent Australian general practice. It is important to emphasise that performance management interventions are available to support the registrar in training. Successful completion of educational interventions will not detrimentally affect a registrar’s career path in any way, including working for the RACGP. Once training is completed information about educational interventions is not a part of the Fellowship record.

Performance concerns in general practice registrars may range from minor, transient concerns to more significant and persistent concerns. They may occur in isolation or, more commonly, in combination, and their presentation may not always be overt but sometimes subtle or disguised. Therefore, depending on the presentation, managing performance concerns in general practice registrars can be complex. However, most problems and concerns that arise are of a minor nature and are easily managed.

The following guidelines for managing performance will enable regional training teams and supervisors to:

• assess and address the needs of general practice registrars having performance concerns
• determine the appropriate level of intervention
• effectively document, manage and evaluate an intervention, including formal remediation.

An overview of RACGP performance management interventions

There are two types of performance management interventions:

1. Focused learning interventions (FLIs) address identified problems that can be readily corrected in the normal course of training using available resources. It does not affect the registrar’s training progression. This form of support addresses one or two discrete concerns and has a low financial cost.
2. Formal remediation plans are required when serious performance concerns are not expected to be readily corrected in the normal course of training and/or where previous focused learning interventions have not succeeded. This intervention suspends training time for the duration of the term. Remediations incur larger costs and address more significant progression concerns e.g. Professionalism, exam fails, clinical reasoning, and insight issues. Applications for funding for remediation terms are made to the National Clinical Lead-Performance Management via registrar.remediation@racgp.org.au.

Performance management intervention plans should be created and assessed with input from the relevant training team, registrar, and supervisor. The following principles and assessment framework are aimed to support the creation and assessment of these plans.