Policy update notice: Changes to the Vocational Training Pathway Requirements for Fellowship policy – 4 September 2019


04 September 2019

Notice of RACGP policy update

This notice is to advise that the RACGP has made a series of changes to the Vocational Training Pathway Requirements for Fellowship Policy, with corresponding changes to the RACGP’s Cardiopulmonary Resuscitation and Advanced Life Support Guidance Document, and the Standards for General Practice Training.

The updates and rationale are outlined below.

Cardiopulmonary Resuscitation and Advanced Life Support Guidance Document

This document has undergone significant amendments, including:

  • Updating of CPR, ALS and BLS terminology
  • Clarification of and updates to the qualifications of approved BLS trainers

The document is now called Basic Life Support and Advanced Life Support Guidance Document, and is available here.

ALS and CPR – Clause 5.1.a and definitions

Current policy position Updated policy position Rationale
Currently, registrars are required to complete:
  • a Cardiopulmonary Resuscitation (CPR) course within the 12 months prior to GPT1
  • a CPR course within the 12 months prior to applying for Fellowship
  • an Advanced Life Support (ALS) course within the four years prior to applying for Fellowship
 
 
Registrars will be required to complete:
  • a Basic Life Support (BLS) course within the 12 months prior to GPT1
  • a BLS course within the 12 months prior to applying for Fellowship
  • an ALS course within the four years prior to applying for Fellowship

Trauma management has been removed from the ALS requirement and instead sits separately, as outlined in the new trauma management guidance document.

The definitions of BLS and ALS have been updated in the policy to reflect ARC terminology.

Trauma management and the ALS requirements have been uncoupled, and a trauma guidance document developed.

 

Terminology and advice around CPR, ALS, BLS and trauma has been updated to align the RACGP with the advice and expertise of the Australian Resuscitation Council (ARC) guidelines.

  • Existing RACGP CPR guidance requires both basic life support and competency assessment, not just CPR; the updated nomenclature better reflects the requirements the document outlines.
  • The ALS component of existing RACGP guidance refers to ALS plus early management of trauma. However, accessible ALS courses nationally vary between those offering training in ALS, and those offering training in ALS plus trauma. Removing the trauma component from this guidance document ensure equity of access across Australia; registrars may complete their requirements via any ALS course approved by the ARC.
  • A new Trauma Management Guidance Document has been developed to provide advice regarding the acquisition and maintenance of trauma management skills; trauma management remains a requirement of the RACGP Curriculum.

Practice diversity requirements & definitions – Clause 5.2.a

Current policy position Updated policy position Rationale

Currently, registrars are required to undertake training in at least two different general practices over the course of the AGPT training, to ensure sufficient exposure to diversity of demographics and presentations (with prospective RACGP approval required for any exemptions).

The clause has been amended to require that registrars are exposed to at least two different supervisors and two different management systems in addition to the requirement of exposure to diverse patient populations.

The requirement now emphasises diversity of experience over number of practices, and is a requirement of all registrars regardless of location.

The change has been made to reflect evolution in practice structures in recent years, and ensures that in any location where there are challenges to registrars being placed in two distinct practices, training continues to provide access to sufficient diversity of experience with regards to patient presentations and demographics, supervision, and practice management systems.

AGPT hospital terms – Clause 5.2.b

Current policy position Updated policy position Rationale

Currently, the policy requires that registrars undertake rotations providing adequate exposure to medicine, surgery, emergency medicine, paediatrics and other rotations relevant to general practice.

The clause has been amended to clarify that hospital rotations relevant to general practice undertaken during training must be clinical in nature.

Adequate exposure to medicine, surgery, emergency medicine and paediatrics is still required prior to commencing in a general practice term.

The intent of the policy has long been to ensure that clinical skills are prioritised during registrar training; the update makes explicit this intent.

The RACGP acknowledges the value of non-clinical hospital rotations; however, for the purposes of vocational training, it is considered appropriate for the hospital year to only include relevant (to general practice) clinical terms.

Standards for General Practice Training

The Standards have been amended to reflect the above changes. The relevant criterion are:

  1. Criterion 1.3.2.1 – alignment of RACGP BLS and ALS requirements with the Requirements for Fellowship Policy.
  2. Criterion 2.3.2.2 – practice diversity requirements updated to align with new process for recognition of diversity.
  3. Criterion 1.3.2.1 – emergency skills and trauma management to align with updated ALS requirement and trauma management guidance.

 

When will these changes take effect?

The updated requirements will be implemented from January 1 2020 onwards, and will affect both registrars already in training and those commencing in 2020.

 

Where can I view the documents?


Enquiries

Policy Coordinator

 Rebecca.Mackinnon@racgp.org.au