FSP accreditation handbook for training sites and supervisors

Expectations of a training site and supervisor

Last revised: 17 Feb 2025

Expectations of a training site and supervisor


Employing a registrar

All registrars must have a formal employment agreement with their training site.

General Practice Supervisors Australia (GPSA) provides resources and templates for practices and supervisors to assist with employment of registrars. If you would like further information, please visit their website.

Registrar employment hours

Full-time training in general practice is a minimum of 27 hrs face-to-face, rostered patient consultation time over a minimum of four days within a minimum 38-hour working week.

Part-time training is a minimum of 10.5 hours face-to-face, rostered patient consultation time over a minimum of two days within a minimum 14.5-hour working week. The maximum working hours are required to be met at each independent training site the registrar works.

Expected patient numbers, demographics and workload

The number of patients a registrar sees shouldn't exceed four patients per hour in a normal general practice setting.

Training sites are expected to provide a full range of patient presentations considered to be 'comprehensive general practice' (refer to the Comprehensive Australian General Practice Guidance Document). This will ensure registrars are exposed to comprehensive and experiential learning on common and significant conditions.

Training sites are also expected to ensure registrars rosters are fair and equitable.

Registrars are required to work in the hours of 8.00 am to 6.00 pm for their time in training and are expected to provide after-hours services that are equitable to other doctors at the practice.

After-hours work is usually not considered comprehensive. The after-hours period is defined as after 6.00 pm and before 8.00 am on weekdays, before 8.00 am and from 12.00 pm onwards on Saturday and all-day Sunday and all public holidays.

Managing fatigue must be considered in rostering registrars (including in-clinic consulting, on-call and after-hours shifts). Travel time and work undertaken external to the clinic such as local hospital cover and nursing home visits, also contribute to a registrar's overall workload. For more information you can read the RACGP policy position statement on stress and fatigue in general practice.

Anti-bullying

All training sites must comply with relevant work health and safety and fair work legislation, and training site staff and supervisors should be familiar with these, including having a zero-tolerance approach to bullying, harassment and discrimination.

Medicare provider numbers

FSP registrars who have accepted their FSP agreement at an accredited training site will be eligible to charge Medicare equivalent to a vocationally registered GP. We will prepare a Medicare provider number application for the registrar. The form must be signed by both the practice and registrar. The RACGP will endorse the signed application and submit it to Medicare.

It can take up to eight weeks once a completed form is submitted for the provider number to be issued to the registrar, so please ensure that the necessary details are completed promptly – at least three months before the FSP term begins.

The role of the practice manager

Practice managers have valuable skills that can be of great benefit to registrars and the smooth running of training. The practice manager is often the first person a registrar will contact with a range of queries.

You can support your registrar by:

  • providing an orientation to the training site (if they are new to that location)
  • providing information on the training site and its systems
  • helping them understand the Medicare Benefits Schedule
  • managing their rostering
  • helping them improve their technology skills
  • giving advice on administrative tasks
  • sharing knowledge of local services
  • helping to resolve issues and problems that may arise
  • advising them on interpersonal skills, such as dealing with confrontation and conflict resolution
  • being aware of when they have allocated teaching time with their supervisor, what their training and study requirements are, and when they are scheduled to sit an exam.

You also have an important role in providing feedback. You'll receive feedback about the registrar from their patients and other practice staff and practitioners. This feedback is valuable in helping the registrar develop their skills, but it does need to be given sensitively.

At the beginning of the training term, discuss the process for two-way feedback with the registrar and their supervisor. You can also assist with aligning expectations from both the employment and training perspectives.

It is important that training is seen as a team activity for the whole training site and not just the supervisor. More detailed information can be found in the FSP Training site and supervisor handbook.


Supervision

Clinical supervision should always be readily available to all registrars while they are working. A supervisor's core tasks include:

  • orientating a registrar to the training site
  • supervising the registrar's intital consultations
  • developing and monitoring a clinical supervision plan
  • providing 'as needed' supervision
  • developing an in-practice teaching plan
  • providing regular uninterrupted teaching sessions
  • giving regular feedback
  • completing required assessments
  • coordinating the supervisory team
  • supporting and advocating for the registrar with the training site and the RACGP
  • evaluating the education and supervision provided.

Clinical supervision plan

As a requirement of accreditation, each training site must have a clinical supervision plan. The supervisor works with the broader supervisory team to develop a plan that details the roles and responsibilities of the team, documents how the registrar can access clinical supervision, and indicates who will provide onsite support when the registrar’s supervisor isn’t available.

The clinical supervision plan should consider:

  • supervision outside usual business hours
  • supervision during home visits
  • supervision whilst the registar is working as a visiting medical officer (VMO) or on-call at a hospital as part of the training site roster
  • supervisor leave (planned or unplanned)
  • the registrar's competence and level of training.

Requirements of leave cover supervision:

  • The initial clinical supervision plan should identify who will cover supervision requirements during periods of leave by noting their name, practice name and address, contact details, Ahpra registration number and whether the cover will be on-site or off-site.
  • The leave cover GP must be a Fellowed GP and have recency of GP practice in the last 12 months.
  • The leave cover GP is required to appear on the Ahpra registrer of practitioners with a status of 'registered' (without any restrictions, conditions, undertakings or suspensions that limit their scope of practice).
  • The leave cover GP is not required to undertake supervision accreditation.
  • Registrars with Medical Board approved suspension must adhere to these requirements during periods their primary board approved supervisor is on leave.
  • For leave greater than two weeks, a supervisor must formally notify the RACGP by completing a change in circumstance - leave notification form. Leave cover arrangements (greater than two weeks) are assessed for approval at the time of lodgement, please ensure you allow sufficient time for processing.

All training time must be supervised. Registrars left without supervision, as defined by their training needs, will be unable to count that time towards training requirements for fellowship.

The supervision team

The supervision team includes the supervisor and any other training site staff. Other members of the supervision team may include other GPs who are not accredited as supervisors, practice nurses, allied health professionals, Aboriginal Health Workers and non-clinical practice staff, all who have experience that can benefit a registrar.

An important requirement for a supervisor is enthusiasm for general practice and a commitment to providing a positive learning experience. It is important that training is seen as a team activity for the whole training site and not just the supervisor. More detailed information can be found in the FSP Training site and supervisor handbook.


Supervisor professional development requirements

Professional development for accredited supervisors is required to be consistent with the National supervisor professional development program.

GPs who wish to become accredited supervisors will be required to complete the Foundations of GP supervision and Introduction to Aboriginal and Torres Strait Islander Cultural Awareness courses.

The Foundations of supervision course consists of eight modules, delivered either as a blend of face-to-face workshops and online modules, or entirely online. The course will take one to two days to complete depending on which option you choose. At this stage, module 8 is not a mandatory component of this course.

New supervisors must complete the first seven modules of Foundations of GP supervision and the Introduction to Aboriginal and Torres Strait Islander Cultural Awareness within 90 days of their registrar commencing.

Continuing supervisor professional development is less prescriptive, and a range of activities is available.

Workshops, small-group learning and peer group learning will complement the initial online learning modules that will be available. GP supervisors may choose activities that interest them or are relevant to their practice.


Orientating the registrar

A well-planned, comprehensive orientation to the training site and the local environment is an essential task for the practice manager, supervisory team and other practice staff to undertake together. It helps ensure the safety (including cultural safety) of the registrar, the training site and the community. This is particularly important for registrars in their first general practice training term. The plan should include information about all aspects of the training site to enable the registrar to function effectively. A recommended orientation checklist is available to help guide your orientation activities.
 

Teaching

Learning plan

Registrars are responsible for planning their own learning. Supervisors help with this planning and review the plan regularly with the registrar.

Minimum hours of teaching time

The mandated teaching time for each level of registrar is:

  • Year 1 (GPT1 and 2) – minimum 1 hour per fortnight of scheduled and uninterrupted time
  • Year 2 (GPT3 and 4) – minimum 1 hour per month of scheduled and uninterrupted time.

For part-time registrars, the minimum teaching time is the same as for full-time registrars.

Each training site is required to develop an in-practice teaching plan that addresses the registrar's learning needs and is consistent with training program requirements.


Workplace-based assessments and feedback

Workplace-based assessment (WBA) involves observation and assessment of a registrar’s practice in the workplace. It allows the registrar’s progress through training to be monitored, ensuring that the registrar receives appropriate support to gain the clinical competencies and skills relevant to their stage of training and to progress to Fellowship.

WBA may involve a range of people, including:

  • supervisor(s)
  • medical educator
  • external clinical teaching visitors (I.e., external assessors)
  • program officer.

After each assessment, feedback is given to the registrar to help them reflect on their progress and plan additional learning activities.

Supervisors are integral to WBA, including direct observation of consultations and procedures, and participation in random case analysis and case-based discussions.

Supervisors provide assessments in the form of feedback reports, focusing on registrar’s competence and progression towards expected levels.

Registrars will also provide feedback on training sites and supervisors at the completion of their training. This feedback is an opportunity for practices to continuously improve as they review their own progress as a learning environment.

We encourage GP supervisors to discuss the progress of their registrars during a WBA.
 

Training site reporting requirements

Throughout a registrar’s placement, reporting by the training site allows us to monitor the requirements of the training site and supervisors, as well as confirm that the registrar is achieving their training outcomes.

Any issues that are identified will be promptly managed by the RACGP team. This may take the form of a discussion with the supervisor and/or practice manager or the provision of additional support or remediation. Any issues will be documented and, if necessary, escalated to the FSP Accreditation Panel.

RACGP and ACRRM have agreed to share appropriate information on practice monitoring for dually accredited practices. Appropriate training site and supervisor information may also be shared between the RACGP training programs (AGPT and FSP).
 

Risk Management

As an employer, the training site, along with the supervisor, has the primary duty of care to ensure, as far as is reasonably practicable, the registrar’s health and safety during their training.

Training sites must comply with work health and safety legislation applicable to their location and advise the training colleges of any safety concerns, risks, hazards or incident that may affect registrars.

Adverse events (including critical incidents) and patient complaint management and reporting are an important part of training management and are a joint responsibility between all parties and a requirement of the Standards. The Adverse management and crtitical incident management reporting guidance document defines what makes an adverse event a critical incident and details the reporting requirements.
 

Payments

Supervisors will be paid by the RACGP for educational supervision (ie in-practice education). In-practice teaching payments will be made monthly in arrears and will be validated by the RACGP to ensure the quality of teaching activity.

You can contact FSPOperations@racgp.org.au for any queries relating to supervisor payment.

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