When a GP has been absent from work for more than 36 months, the Board’s requirement is that they work under supervision. In some instances, the Board may also require a formal assessment of clinical skills prior to re-entry. Sometimes, the required level of supervision as well as its duration is stipulated by the Board. The Board will inform the GP, when applying for re-entry, about any such requirements for assessment and/or supervision.
Good supervision and feedback within a supportive environment enhances the improvement of clinical skills. It promotes the practitioner’s strengths, elucidates the areas that need improvement and provides direction and strategies for improving performance. Even if the Board doesn’t mandate it, supervision is advisable for any GP who has been away from practice for a substantial period of time, because it:
- provides evidence as to the practitioner’s safety to practice and that the public is not at risk
- monitors and supports the practitioner throughout the duration of the re-entry plan to ensure that objectives are being met.
The need for supervision will be influenced by individual circumstances, including the:
- reasons for absence
- length of time away
- specific practice where the practitioner will be working (ie patient demographics and any associated risks)
- supports that will be in place (other than the supervisor)
- experience of the practitioner.
Supervision should be both formal and informal, tailored to the GP’s needs:
- Formal supervision involves regular, scheduled time that enables in-depth discussion and reflection on clinical practice. It may include
- review and feedback on performance, identifying strengths and weaknesses and performance issues
- direct observation of consultations, including procedures
- case discussion, including random case analysis
- prescribing and medical record reviews
- review of systems and practice procedures.
- Informal supervision may include
- day-to-day observation, communication and interaction providing advice, guidance and support as required (many learning needs will arise during the course of consulting)
- observing the supervisor’s consulting.
The supervisor should be onsite when a re-entry GP is practising. When the supervisor is not onsite, they should be readily available by phone, or a secondary supervisor should be nominated to provide assistance.
Supervision should be directed towards self-management, starting with a higher level of supervision for an initial period and gradually reducing over a defined period. The level of supervision and its duration will be influenced by the re-entry GP’s skill level, confidence and rate of progress.