1. Practice Experience Program – Specialist Stream Supervision Policy
1.1 Policy number: CO-E-0054.0
1.2 Category: Education
1.3 Approval date: September 2019
1.4 Revision due date: September 2022
1.5 Unit responsible: Education Services
2. Policy declaration
The Medical Board of Australia (the Medical Board) requires that specialist international medical graduates (SIMGs) be supervised for the duration of their limited registration or provisional registration. This policy should be read in conjunction with the Board Guidelines – Supervised Practice of International medical graduates.
3. Background, objectives and scope
- The PEP Specialist Stream is the pathway to Fellowship of the RACGP available to SIMGs. Previous iterations of this pathway include:
- the Specialist Pathway Program (SPP), which ran from 2010 to 2018, and categorised SIMGs as Category 1, 2 or 3, or not comparable; and
- the Specialist Recognition Program (SRP), which superseded the SPP from 2018 to 2019.
- From 1 September 2019, the Specialist Pathway to Fellowship will fall under the PEP as a specialist stream. This adjustment supports the removal of Fellowship ad eudem gradum (FAEG) to ensure a robust and more uniform approach to the assessment of SIMGs. From this time, SIMGs will be required to work under supervision under limited or provisional registration from the Medical Board of Australia. The RACGP will issue PEP provider numbers to eligible SIMGs to permit access to A1 Medicare rebates.
This policy aims to describe the supervision requirements for participants of the PEP Specialist Stream, as required by the Board.
This policy applies to SIMGs wishing to pursue Fellowship of the RACGP via the PEP Specialist Stream and their supervisors.
For the purposes of this policy:
- Board means the Medical Board of Australia.
- Comparable/comparability means the extent to which an SIMG’s recency is assessed as equivalent to an Australian-trained specialist general practitioner at the point of Fellowship.
- Substantially comparable means the applicant has been assessed as suitable to undertake the intended scope of practice, taking full responsibility for all patients, with limited oversight of their practice by a supervisor (peer review) and reach comparability within 12 months’ full time equivalent (FTE) practice, with a maximum time on the program of 24 months if working part time;
- Partially comparable means the applicant has been assessed as suitable to undertake a defined scope of practice in a supervised capacity and able to reach comparability within 24 months’ full time equivalent (FTE) practice, with a maximum time on the program of 48 months if working part time.
- Multi Source Feedback (MSF) consists of three components – a colleague feedback assessment tool, a patient assessment tool, and a reflective task.
- FACRRM means Fellowship of the Australian College of Rural and Remote Medicine.
- FRACGP means Fellowship of the RACGP.
- Participant means a medical practitioner who has been accepted into the PEP Specialist Stream.
- PEP Specialist Stream means the route to Fellowship available to SIMGs who have been assessed as substantially or partially comparable to an Australian-trained specialist general practitioner at the point of Fellowship.
- Recency means clinical recency in general practice, and is not synonymous with continuity of employment.
- Specialist GP means a medical practitioner who holds specialist registration in general practice with the Medical Board of Australia.
- Supervision/supervised practice means supervision in line with the principles of supervision and supervised practice, based upon the prescribed Medical Board of Australia Guidelines – Supervised Practice of International Medical Graduates.
- Workplace Based Assessment (WBA) provides a framework for evaluating a doctor’s performance and progress in those areas of practice best assessed in the context of the workplace. The aim is to provide evidence that the SIMG is competent for unsupervised practice in Australia. The WBA program will include MSF, clinical assessment, a learning unit reflection task, and supervisor reports.
5. General principles
5.1 Supervision requirements
5.1.1 Applicants to the PEP Specialist Stream are required to undertake a Comparability Assessment to determine eligibility prior to applying for entry into the Program. The process for applying for a Comparability Assessment is detailed in A Guide to Completing the Practice Experience Program – Specialist Stream Comparability Assessment.
5.1.2 The Medical Board determines an SIMG’s supervision level and supervisor, depending on the particular employment arrangements.
5.1.3 The levels of supervision in general practice positions are specified in clause 6.2 of the Board Guidelines – Supervised Practice of International medical graduates.
5.1.4 The RACGP makes recommendations to the Medical Board on the supervision requirements for SIMGs in general practice. When making a recommendation, the RACGP will consider factors including the participant’s:
- assessment of partial or substantial comparability; and
- intended practice.
5.1.5 The Medical Board is not required to accept an RACGP recommendation.
5.2 Recommended levels of supervision
5.2.1 Unless varied by clauses 5.2.2 – 5.2.3 below, Level 3 supervision will be recommended for all participants.
5.2.2 Level 2 supervision will be recommended if the participant failed to meet the recency requirements as detailed in the Practice Experience Program – Specialist Stream Comparability Assessment Policy, but was granted entry into the PEP Specialist Stream as per clause 5.3.7, 5.3.8 or 5.3.9 of the Practice Experience Program – Specialist Stream Assessment of Recency Policy.
5.2.3 A participant’s recommended level of supervision will be reviewed after the RACGP receives the results of the Workplace Based Assessment (WBA) undertaken at least three months after the participant has commenced work in Australia. A higher or lower level of supervision may be recommended if deemed appropriate by the RACGP.
5.3 Supervisor approval
5.3.1 The RACGP recommends that the supervisor:
- has full and unrestricted registration as a specialist GP under the Australian Health Practitioner Regulation Agency;
- has attained Fellowship of the RACGP (FRACGP) and/or Fellowship of the Australian College of Rural and Remote Medicine (FACRRM), or has a written recommendation by a Fellowed GP in support of their application as supervisor.
6. Related policies, documents and legislation
All related policies and procedures are available on our policy page.
7. Administrative procedures
7.1 Access to published policy
This policy will be available via the RACGP website as detailed in clause 6.
7.2 Promulgation of published policy
Relevant staff members will be provided communications explaining the function and role of this policy.
7.3 Review of this policy
This policy will have a review cycle of one year.