Currently, the RACGP has a Fellowship Pathways Policy Framework that supports, informs and guides GPs and education providers involved in each of the three pathways to Fellowship. The policies within the Framework (hereafter, education policies) provide a guide for what is expected of GPs in training, and for those who manage and deliver RACGP education both within the RACGP and as external stakeholders.
The education policies currently sit across the three main pathways to RACGP Fellowship: Vocational Training, General Practice Experience and Specialist pathways. Each pathway contains one or two educational programs. Some policies span all pathways, such as the Fellowship Exam Attempts or Academic Misconduct policies, but the majority are specific to a particular pathway or program.
These policies are currently used by:
- GPs in training to inform them of what is necessary to complete their pathway to gain Fellowship
- education providers to guide their delivery of training programs for pre-Fellowship GPs
- RACGP staff to:
- assess eligibility for training programs and examinations
- assess requirements for Fellowship and recognition of prior learning
- process appeals and reconsiderations from GPs in training
- make decisions regarding special arrangements in assessments and exams, special consideration for extenuating and unforeseen circumstances and applications for leave from GPs in training
- provide policy advice to GPs in training and education providers.
Strengths of the current education policies are that they:
- are based on stated, credible principles
- provide guidance and parameters to a multitude of stakeholders
- are peer reviewed.
Areas for further development include addressing:
- contradictions between clauses in different policies
- a lack of consistent tone of voice or style
- a lack of clarity about the alignment of the policies and their overarching principles
- separate policies existing for the same process across multiple pathways and programs
- a lack of flexibility in application, necessary for differing local contexts across Australia
- insufficient detail for intended target audiences such that the policy requirements are not meaningful or not clear to them
- processes related to policy interpretation and rulings that can be complicated and convoluted
- ambiguities regarding the correct process or procedure to follow
- responsiveness to changing landscapes and the evolving nature of general practice
- absence of policies in key areas, including
- continuing professional development (CPD) (ie post-Fellowship education or specific interests education)
- GPs who need support, remediation or help in return to practice after training
- meeting the health needs of Aboriginal and Torres Strait Islander peoples.
There are two sets of standards that inform general practice education:
The Training Standards define the requirements for selection and entry into general practice training, and the benchmark for all training providers delivering this training. The Training Standards are outcomes based and reflect contemporary best practice in training. Their purpose is to ensure safe, high-quality general practice education.
The Training Standards are divided into three areas:
- supervision and the practice environment
- education and training/teaching
Under each area are relevant standards and associated outcomes, each with a set of criteria for judging the outcome. Attached to each criterion are requirements and guidelines detailing what training organisations need to provide as evidence that criteria are being met.
The Training Standards are used by:
- general practices and supervisors to inform their training and supervision of GPs in training
- training organisations to inform their educational programs and gain RACGP accreditation of training posts
- RACGP staff to guide their decisions regarding the accreditation of training organisations by the RACGP and questions around sufficiency of training organisation models of training
- the Australian Medical Council (AMC) to judge the sufficiency of RACGP-led training.
Strengths of the Training Standards include that they:
- are clearly structured
- are outcomes based
- emphasise the importance of Aboriginal and Torres Strait Islander cultural competency
- endeavour to provide training program contextual flexibility while ensuring accountability and alignment of education with the broader social imperatives the RACGP must meet.
Areas for development include:
- providing clearer metrics for stated outcomes for assessment and monitoring
- revising the requirements and guidelines sections, which are currently not well demarcated and include a range of inputs as well as outcomes
- ensuring clearer alignment with the Medical Board of Australia’s (MBA’s) Good medical practice, which describes what is expected of all doctors registered to practise medicine in Australia10
- outlining clearer alignment with the AMC accreditation requirements.
The CPD Standards outline the requirements for GP CPD learning activities to ensure their design is based on sound educational principles, are linked to the Curriculum and are relevant to GPs.
The CPD Standards are used by:
- education providers to guide development of their GP CPD learning activities and to gain formal accreditation as CPD-recognised activities
- RACGP staff to assess applications for accreditation of CPD activities
- GPs to ensure they are meeting the CPD requirements of the RACGP and MBA
- the MBA in its accreditation of the RACGP CPD Program.
Key strengths of the CPD Standards include that they are:
- well organised, clear and usable
- detailed in their explanations and examples.
Areas for further development of the CPD Standards include:
- greater accessibility – they are currently in the provider’s handbook as an appendix
- clearer connection to other educational polices and standards
- a separation of detailed description of requirements and processes from the main document.