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Professional support over the general practice continuum


Professional support for GPs

The professional life of a GP commences in medical school where the foundations of medicine are laid and one’s identity as a doctor comes into being. This identity grows and is continually shaped along the path leading to Fellowship and continuing beyond it. Identity as a doctor is inextricably connected to personal identity. Identity strongly influences how a GP practises and behaves professionally and how a GP’s values are reconciled with the expectations of the community, the medical profession and the regulatory bodies. It can take unexpected turns or be interrupted at various points along the way, sometimes by choice, other times because of unforeseen situations.

There are two types of issues that a GP might be faced with, at any time in their working life:

  1. clinical capability (performance concerns)
  2. illness and disability.

Time away from practice, whether by choice or enforced, also has implications for clinical capability. Skills can deteriorate in that time away, and return to practice may prove to be more difficult than anticipated. A GP finding themselves in any of these circumstances would benefit from support.

Performance concerns may arise at any stage: from the GP early in training to the Fellowed GP with many years of experience. How performance concerns are addressed will depend on the GP’s stage in their career path:

  • working towards attaining Fellowship: Australian General Practice Training (AGPT) program or Remote Vocational Training Scheme (RVTS)
  • working towards attaining Fellowship: Practice Experience Pathway (PEP) or unsupported (non–vocationally registered [non-VR])
  • undertaking the Fellowship exam
  • as a Fellowed GP (including the ageing GP and transition to retirement).

GP health underpins all of these areas. Stress can come from many quarters but primarily from the continual stresses of general practice. The situation may be made worse as a result of personal vulnerabilities that the GP may be experiencing at different times along the path. Stress has significant implications for wellbeing and clinical performance. For these reasons, the importance of self-care cannot be emphasised enough, but also because GPs, on the whole, are not as conscientious about self-care as they ought to.

The RACGP has produced a series of guides relating to each stage where a GP might require support:

The first four guides are primarily for medical educators and supervisors who are managing performance concerns in each domain.

The guide to performance management and support, because of its focus on prevention, is useful for individual GPs, practices and practice managers, to reflect on and improve clinical practice and processes.

The guide to re-entry is for individual GPs (Fellowed or non-VR) who are intending to take time away from practice or planning to return to practice. While general practice registrars in this position will generally be assisted by their training organisation, much of the information in this guide is also relevant to them.

Figure 1 is a map to the general practice continuum, with links to the relevant sections.

 
 

Practice Experience Program (Section 2, Section 3, Section 4)

Unsupported, non-vocationally registered (Section 3, Section 4)

 

Planning to leave practice (Section 5)
Plan to re-enter practice (Section 5)

Medical student/
junior doctor

Australian General Practice Training/
Remote Vocational Training Scheme
(Section 1)

Fellowship exam
(Section 3)

Fellowed GP
(Section 4)

Ageing GP
(Section 4)

Transition to retirement

GP health (Section 6)