Appendix 2: Curriculum for Australian General Practice

The Curriculum for Australian General Practice (the Curriculum) has changed format several times since its inception. The current version of the Curriculum was released in 2016. It provides competency-based outcomes across the general practitioner (GP) learning continuum, from entry to general practice training, to GP practice under supervision to post-Fellowship learning. It is composed of several documents and levels, as detailed below. Current and older versions of the Curriculum are available on the website

The components of the 2016 Curriculum are:

• core skills units
  • Core skills unit (CS16)
  • Rural health core skills unit (RH16)
  • Aboriginal and Torres Strait Islander health core skills unit (AH16)
• contextual units.

The core skills units are arranged in a competency and outcomes framework, with competencies and outcomes grouped in a hierarchical way:

1. Pre–general practice (121)
2. General practice under supervision (145)
3. General practice – lifelong learning (77)

At the top level are five discipline-specific categories known as the ‘domains’ of general practice, each representing a major concept in the scope of general practice. Under each domains is a small number of global ‘core skills’ that describe, at a high level, the activities, behaviours, skills and attributes of the Australian GP. These are detailed with greater detail under the ‘competency outcomes’ and their component ‘criteria’. The criteria are divided into three conceptual stages in life-long learning. The core skills are common across each of the three curriculum units (CS16, RH16 and AH16), while the competency outcomes and criteria are specific to each unit.

The ‘contextual units’ are short overviews of different areas of activity that GPs undertake.

Assessment processes and content currently sit external to the Curriculum and are managed separately.

• medical educators and education providers to develop their training programs
• The Royal Australian College of General Practitioners (RACGP) assessment team, which maps exam questions and assessments against the Curriculum. These assessments include those used for selection into general practice training, assessing progress and for examining suitability for Fellowship
• GPs in training as a guide for their learning and exam preparation.

Identified areas for development within the Curriculum include:

• revising the Curriculum structure, including
  • strengthening the underlying competency and outcomes framework^45–47
  • anchoring it to the Profile of the GP
  • aligning it with benchmarked international models of competency-based
    medical education^44,45,48
  • improving mapping between outcomes, competencies and assessment
  • improving accessibility
• aligning the Curriculum with current expectations of a curriculum⁴⁹ to include
  • programs of assessment⁵⁰
  • detailed syllabus with differentiation of different types of knowing
    (eg information/skills/values and codified/tacit)^51,52
  • flexible educational processes, in accordance with Australia’s diversity and vast geographical footprint
  • mapping of types of knowing to educational processes^51,53
• extending the scope of the Curriculum to cover all RACGP education, including
  • programs on the General Practice Experience Pathway to Fellowship
  • continuing professional development (CPD)
  • extended skills
• reinforcing a focus on education that addresses social inequity related to
  • Aboriginal and Torres Strait Islander health
  • culturally and linguistically diverse (CALD) population groups
  • people with disabilities
  • lesbian, gay, bisexual, transgender/gender diverse, intersex and queer (LGBTIQ+) communities
  • refugee groups
• supporting doctors who are
  • international medical graduates
  • Aboriginal or Torres Strait Islander
• expanding areas of the Curriculum that are currently under-represented, including
  • social determinants of health⁵⁴
  • GPs as health advocates⁵⁵
  • patient health literacy
  • identified priority areas (national⁵ and RACGP identified)
  • reflective learning^56,57
  • GP health and wellbeing/self-care⁵⁸
  • facilitation behaviour change models⁵⁴
  • leadership, research and teaching^59–61
  • digital literacy⁶²
  • climate change and its impact on health
  • practice management⁶³
• an ongoing plan for evaluation and review, and a robust process of ongoing
  quality improvement.^64–65

As a guiding instrument, the Curriculum will clearly articulate the skills, knowledge, values and behaviours of the Australian GP, and be a true representation of contemporary medical education. It will provide a coherent and logical picture of the subjects to be studied, the teaching, learning and assessment processes to be used and the intended outcomes of the education.⁴² It will also aim to ensure that general practice education is relevant, high quality, and meets the needs of pre- and post-Fellowship GPs, their educators and supervisors, patients and the diverse Australian community.

To meet this purpose, the Curriculum will need to:

• include an overarching competency framework, including syllabus, facilitation methods and assessment requirements
• provide a clear set of definitions and terminology and consistent use of language
• clearly articulate measurable global outcomes that correspond with the Profile of the GP
• align with international models and be supported by current literature and best practice methods
• be applicable across a range of contexts and the full length of the GP professional life, from pre-GP terms through to Fellowship training and CPD
• be informed by the RACGP educational guiding principles and internal and external general practice educational imperatives
• demonstrate cultural responsiveness by reflecting Australia’s diverse population and the local needs of Australians through consultation with relevant stakeholders, including but not limited to the RACGP Aboriginal and Torres Strait Islander Health faculty, RACGP Rural faculty, RACGP Specific Interests faculty and the Migrant and Refugee Health Partnership.

The Curriculum is reviewed and revised every 3–5 years. It entered its current review cycle in 2019, and is expected to be released ahead of the transition from the Australian General Practice Training (AGPT) Program and the Remote Vocational Training Scheme to RACGP-led training in 2022.

The first steps in moving the Curriculum towards its future vision are:

• identifying key national and international frameworks that inform Curriculum development^{40–42,44,66,67}
• identifying key literature that informs Curriculum development^49,68
• creating a consultation plan
• reviewing content for currency and accuracy and checking for content gaps
• determining consistent terminology, definitions and language to be used within the instrument
• creating plans for
  • achieving better alignment with the other parts of the RACGP educational framework
  • building greater cohesion within the current parts of the Curriculum
  • including assessment as part of the Curriculum
  • building a syllabus
  • including educational processes within the Curriculum.

Overarching objectives for future reviews include creating a cohesive and coherent Curriculum that:

• achieves national consistency in RACGP education while recognising the need for regional flexibility
• is based on contemporary competency- and outcomes-based medical education
• is internally cohesive
• includes educational content, processes and assessment as well as educational outcomes
• has an embedded evaluation cycle
• has high utility across all education providers.