RACGP educational framework

The RACGP educational framework

Appendix 3: RACGP education policies and standards

Last revised: 17 Feb 2021

The policies refer to a set of parameters that provide high-level operational direction for educational programs and processes for The Royal Australian College of General Practitioners (RACGP), medical education providers and general practitioners (GPs) in training.

The standards refer to the codes of behaviour used to communicate the values, ethical principles and expectations of the RACGP and regulatory bodies.

The policies and standards are addressed separately below.

Education policies

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.

Education standards

There are two sets of standards that inform general practice education:

Training Standards

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
  • assessment.

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.

CPD Standards

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.

The RACGP educational framework and education policies and standards operationalise the RACGP educational guiding principles, giving sound direction to general practice learners, educators and educational programs. The guidance provided ensures that GPs in training and post-training make safe, competent and relevant contributions across the full range of contexts of GP activity in Australia. They also ensure national and international regulatory standards of training and practice are met.

To achieve this future vision, the education policies and standards need to:

  • be coherent and consistent across all pathways to Fellowship and education post-Fellowship
  • clearly reflect the RACGP educational guiding principles
  • have a review structure that is responsive to changing educational imperatives
  • define the minimum expectations of GPs throughout their careers
  • allow flexibility for local application across different contexts in Australia while providing national consistency to ensure defensible decision making
  • protect stakeholders and ensure equity and fairness as well as procedural fairness
  • ensure doctors have safe and accessible pathways to seek support or recourse through their education provider and, if necessary, the RACGP
  • outline the explicit requirements of culturally safe Aboriginal and Torres Strait Islander and culturally and linguistically diverse (CALD) health education
  • ensure RACGP education meets the standards and outcomes required by AMC, the Department of Health and other regulatory bodies.

Future development of education policies and standards will be organised, strategic and involve consultation with internal and external stakeholders.

Consultation and collaboration between RACGP divisions and teams as well as external stakeholders will be required to ensure alignment across all RACGP education policies and standards. Stakeholders to be involved include:

  • RACGP staff, including but not limited to faculty censors, clinical leads and staff who work within policy, CPD, remediation and education strategy and development
  • education providers
  • GPs in training and post-Fellowship GPs
  • GP advocacy bodies (eg General Practice Registrars Australia and General Practice Supervisors Australia)
  • community representatives, including
    • those from rural areas
    • Aboriginal and Torres Strait Islander peoples
    • those from populations with particular needs, including CALD communities; lesbian, gay, bisexual, transgender/gender diverse, intersex and queer (LGBTIQ+) communities; people with a disability; and migrant and refugee groups
  • RACGP Council of Censors
  • RACGP Board, whose approval is required for all policy development.

Future development will need to take a comprehensive approach that is integrated with revisions to other parts of the RACGP educational framework and informed by the impact of policy on education programs. Regular reviews and evaluation of the policies and standards will also need to be scheduled to ensure they remain relevant and in accordance with the imperatives of the RACGP educational framework.

For the education polices and standards, priorities for revision include:

  • establishing and enacting a clear evaluation process that has mechanisms for collecting and considering feedback form relevant stakeholders
  • a mapping process that identifies:
    • which educational guiding principle/s each policy and standard relates to
    • standards and outcomes required by regulatory bodies that RACGP education needs to meet (eg the MBA’s Good medical practice and AMC accreditation requirements).

Recommendations for revision of the education policies include:

  • establishing a working group that will review current policies to ensure
    • consistency across all policies
    • clarity on the principle behind each policy
    • procedural information is removed to become part of working documents
    • the policies are outcomes-focused.
  • prioritising revision of the Vocational Training Pathway policies as part of the transition from the Australian General Practice Training (AGPT) Program and the Remote Vocational Training Scheme to the RACGP; other pathways will follow as per review cycles and program development
  • integrating Rural Generalist Pathway policies into the existing policy framework
  • developing an overarching policy for post-Fellowship education in collaboration with remediation and CPD teams
  • creating an overarching ‘Education Policy Framework’ so that all policies related to general practice education are clearly arranged in an interconnected and easily comprehendible manner. The policy framework will include
    • pre-Fellowship education policies
    • Fellowship educational policies
    • post-Fellowship training policies, including CPD-specific policies
    • policies relating to post-Fellowship GPs who need support, remediation or return to practice help
    • guidance documents that add supplementary operational detail to the policies, to ensure greater clarity and workability for the stakeholders involved in the application of the policies (ie RACGP staff, education providers)
  • improving accessibility to policies and the policy framework.

Recommendations for revision of the Training Standards include refining their focus on outcomes. The policy team will lead this development in consultation with education providers, the Council of Censors and other stakeholders.

The CPD Standards will be revised every three years, ensuring that they meet regulatory requirements. GP CPD education providers and GPs will be consulted on the guidelines provided for meeting these standards.
  1. Thomas H, Mitchell G, Rich J, et al. Definition of whole person care in general practice in the English language literature: A systematic review. BMJ Open 2018;8:e023758. doi: 10.1136/bmjopen-2018-023758.
  2. Australian Commission on Safety and Quality in Health Care. Person-centred care. ACSQHC, 2019 [Accessed 3 August 2020].
  3. Australian Bureau of Statistics. Patient experiences in Australia: Summary of findings, 2018–19. Canberra: ABS, 2019 [Accessed 20 July 2020].
  4. Starfield B, Shi L, Macinko J. Contribution of primary care to health systems and health. Milbank Q 2005;83(3):457–502. doi: 10.1111/j.1468-0009.2005.00409.x. [Accessed 20 July 2020].
  5. Parliament of Australia. The National Health Priority Areas initiative. Current Issues Brief 18 1999–2000. Canberra: Parliament of Australia, 2000 [Accessed 3 August 2020].
  6. The Royal Australian College of General Practitioners. What is general practice? East Melbourne, Vic: RACGP, 2020 [Accessed 20 July 2020].
  7. World Health Organization. Closing the gap in a generation: Healthy equity through action on the social determinants of health: Final report of the Commission on Social Determinants of Health. Geneva: WHO, 2008 [Accessed 21 July 2020].
  8. The Royal Australian College of General Practitioners. RACGP strategic plan 2020–22. East Melbourne, Vic: RACGP, 2020 [Accessed 12 January 2021].
  9. Leeder S, Corbett S, Usherwood T. General practice registrar education beyond the practice: The public health role of general practitioners. Aust Fam Physician 2016;45(5):266–69 [Accessed 19 November 2020].
  10. Medical Board of Australia. Good medical practice: A code of conduct for doctors in Australia. Melbourne: MBA, 2014 [Accessed 20 July 2020].
  11. Breen KJ, Cordner SM, Thomson CJ, Plueckhahsin, V. Good medical practice: Professionalism, ethics and law. New York. Cambridge University Press, 2010. [Accessed 20 July 2020].
  12. Australian Commission on Safety and Quality in Health Care. Australian Open Disclosure Framework – Better communication, a better way to care. Sydney: ACSQHC, 2013 [Accessed 19 November 2020].
  13. Sturman NJ, Saiepour N. Ethics and professionalism in general practice placements: What should students learn? Aust Fam Physician 2014;43(7):468–72 [Accessed 19 November 2020].
  14. World Health Organization. 71st World Health Assembly (WHA) Resolution WHA71.7 on Digital Health. Geneva: WHO, 2018 [Accessed 19 November 2020].
  15. The Royal Australian College of General Practitioners. Views and attitudes towards technological innovation in general practice: Survey report 2017. East Melbourne, Vic: RACGP, 2018 [Accessed 19 November 2019].
  16. Rees C, Francis B, Pollard A. The state of medical education research: What can we learn from the outcomes of the UK Research Excellence Framework? Medical Education 2015;49(5):446–48. [Accessed 19 November 2019].
  17. Brown J, Bearman M, Kirby C, Molloy E, Colville D, Nestel D. Theory, a lost character? As presented in general practice education research papers. Medical Education 2019;53(5):443–57. [Accessed 19 November 2019].
  18. Knowles MS, Holton EF III, Swanson RA. The adult learner: The definitive classic in adult education and human resource development. 7th edn. London: Routledge, 2012. [Accessed 19 November 2019].
  19. Schön DA. The reflective practitioner: How professionals think in action. New York: Basic Books, 1983. [Accessed 19 November 2019].
  20. Kolb DA. Experiential learning: Experience as the source of learning and development. 2nd edn. Upper Saddle River, NJ: Pearson FT Press, 2015. [Accessed 19 November 2019].
  21. Wenger E. Communities of practice: Learning, meaning, and identity. Cambridge: Cambridge University Press, 1998. [Accessed 19 November 2019].
  22. Billett S. Toward a workplace pedagogy: Guidance, participation, and engagement. Adult Education Quarterly 2002;53(1):27–43. [Accessed 19 November 2019].
  23. Engeström Y, Miettinen R, Punamäki RL. Perspectives on activity theory. Cambridge: Cambridge University Press, 1999. [Accessed 19 November 2019].
  24. Carraccio C, Englander R, Van Melle E, et al. Advancing competency-based medical education: A charter for clinician–educators. Acad Med 2016;91(5):645–49. [Accessed 19 November 2019].
  25. Australian Medical Council. Competence-based medical education. Consultation paper. Kingston, ACT: AMC, 2010 [Accessed 21 July 2020].
  26. Pangaro L, Ten Cate O. Frameworks for learner assessment in medicine: AMEE Guide No. 78, Medical Teacher 2013;35(6):e1197–1210 direct=true&AuthType=sso&db=edsbl&AN=RN333042111&site=eds-live&scope=site [Accessed 20 July 2020].
  27. Torre DM, Schuwirth LWT, Van der Vleuten CPM. Theoretical considerations on programmatic assessment. Med Teach 2020;42(2):213–220. doi: 10.1080/0142159X.2019.1672863. [Accessed 20 July 2020].
  28. Lockyer J, Carraccio C, Chan MK, et al, on behalf of the ICBME collaborators. Core principles of assessment in competency-based medical education. Med Teach 2017;39(6):609–16. doi:10.1080/0142159X.2017.1315082. [Accessed 20 July 2020].
  29. Norcini J, Burch V. Workplace-based assessment as an educational tool. AMEE Guide No. 31. Med Teach 2007;29(9):855–58. [Accessed 20 July 2020].
  30. Brown J, Kirby C, Wearne S, Snadden D. Remodelling general practice training: Tension and innovation. Aust J Gen Pract 2019;48(11):773–78 [Accessed 19 November 2020].
  31. Bartle E, Thistlewaite E. Becoming a medical educator: Motivation, socialisation and navigation. BMC Med Ed 2014;14, Article 110. doi: 10.1186/1472-6920-14-110. [Accessed 19 November 2020].
  32. Windsor J, Searle J, Hanney A, et al. Building a sustainable clinical academic workforce to meet the future healthcare needs of Australian and New Zealand: Report from the first summit meeting. Intern Med J 2015;45(9):965–71. doi: 10.1111/imj.12854. [Accessed 19 November 2020].
  33. beyondblue. National Mental Health Survey of Doctors and Medical Students. Hawthorn, Vic: beyondblue, 2013 [Accessed 19 November 2020].
  34. The Royal Australian College of General Practitioners. Self-care and mental health resources for general practitioners. East Melbourne, Vic: RACGP, 2018 [Accessed 19 November 2020].
  35. National Rural Health Commissioner. National Rural Generalist Taskforce: Advice to the National Rural Health Commissioner on the development of the National Rural Generalist Pathway. Canberra: National Rural Generalist Taskforce, 2018 [Accessed 20 July 2020].
  36. Coalition of Peaks. National Agreement on Closing the Gap, 2020. Canberra: Coalition of Peaks, 2020 [Accessed 20 July 2020].
  37. The Royal Australian College of General Practitioners. Aboriginal and Torres Strait Islander health: Position statement. East Melbourne, Vic: RACGP, 2017 [Accessed 20 July 2020].
  38. Queensland Government. Health Practitioner Regulation National Law Act 2009 [Accessed 20 July 2020].
  39. Medical Board of Australia. Registration standard: Continuing professional development. Melbourne: MBA, 2016 [Accessed 20 July 2020].
  40. Australian Medical Council. Standards for assessment and accreditation of specialist medical programs and professional development programs by the Australian Medical Council 2015. Kingston, ACT: AMC, 2015 [Accessed 20 July 2020].
  41. Andresen L. A useable, trans-disciplinary conception of scholarship. Higher education research and development 2000;19(2):137–53. [Accessed 20 July 2020].
  42. Swanwick T, Forrest KAT, O’Brien BC. Understanding medical education: Evidence, theory, and practice. 3rd edn. Hoboken, NJ: Wiley-Blackwell, 2018. [Accessed 20 July 2020].
  43. Australian Qualifications Framework Council. Australian qualifications framework. 2nd edn. Canberra: AQFC Council, 2013 [Accessed 3 August 2020].
  44. Confederation of Postgraduate Medical Education Councils. Australian curriculum framework for junior doctors. Version 3.1. Melbourne: CPMEC, 2012 [Accessed 3 August 2020].
  45. Englander R, Cameron T, Ballard AJ, Dodge J, Bull J, Aschenbrener CA. Toward a common taxonomy of competency domains for the health professions and competencies for physicians. Acad Med 2013;88(8):1088–94. doi: 10.1097/ACM.0b013e31829a3b2b. [Accessed 3 August 2020].
  46. Weggemans MM, van Dijk B, van Dooijeweert B, Veenendaal AG, Ten Cate O. The postgraduate medical education pathway: An international comparison. GMS J Med Educ 2017;34(5):Doc63. [Accessed 3 August 2020].
  47. Holmboe ES, Sherbino J, Englander R, Snell L, Frank JR, on behalf of the ICBME collaborators. A call to action: The controversy of and rationale for competency-based medical education. Med Teach 2017;39(6):574–81.doi: 10.1080/0142159X.2017.1315067. [Accessed 3 August 2020].
  48. Ten Cate O. Competency-based postgraduate medical education: Past, present and future. GMS J Med Educ 2017;34(5):Doc69. doi: 10.3205/zma001146. [Accessed 3 August 2020].
  49. Grant J. Understanding medical education: Evidence, theory and practice. 2nd edn. London: John Wiley & Sons, 2014. [Accessed 3 August 2020].
  50. Ten Cate O, Carraccio C. Envisioning a true continuum of competency-based medical education, training, and practice. Acad Med 2019;94(9):1283–88. doi: 10.1097/ACM.0000000000002687. [Accessed 3 August 2020].
  51. Swanwick T, Forrest K, O’Brien BC, editors. Understanding medical education: Evidence, theory and practice. Hoboken, NJ: Wiley Blackwell, 2011. [Accessed 3 August 2020].
  52. Eraut M. Informal learning in the workplace. Stud Contin Educ 2004;26(2):247–73. [Accessed 3 August 2020].
  53. Billett S. Authenticity and a culture of practice within modes of skill development. Australian and New Zealand Journal of Vocational Education Research 1993;2(1):1–29. [Accessed 3 August 2020].
  54. Hunter, K, Thomson, B. A scoping review of social determinants of health curricula in post-graduate medical education. Can Med Educ J 2019;10(3):e61–71 [Accessed 20 November 2020].
  55. McDonald M, Lavelle C, Wen M, Sherbino J, Hulme J. The state of health advocacy training in postgraduate medical education: A scoping review. Med Educ 2019;53(12):1209–20. doi: 10.1111/medu.13929. [Accessed 20 November 2020].
  56. de la Croix A, Veen M. The reflective zombie: Problematizing the conceptual framework of reflection in medical education. Perspect Med Educ 2018;7(6):394–400. doi:10.1007/s40037-018-0479-9. [Accessed 20 November 2020].
  57. Schei E, Fuks A, Boudreau JD. Reflection in medical education: Intellectual humility, discovery, and know-how. Med Health Care Philos 2019;22(2):167–78. doi: 10.1007/s11019-018-9878-2. [Accessed 20 November 2020].
  58. Sales B, Macdonald A, Scallan S, Crane S. How can educators support general practice (GP) trainees to develop resilience to prevent burnout? Educ Prim Care 2016;27(6):487–93. doi:10.1080/14739879.2016.1217170. [Accessed 20 November 2020].
  59. Sultan N, Torti J, Haddara W, Inayat A, Inayat H, Lingard L. Leadership development in postgraduate medical education: A systematic review of the literature. Acad Med 2109;94(3):440–49. doi:10.1097/ACM.0000000000002503. [Accessed 20 November 2020].
  60. Sadowski B, Cantrell S, Barelski A, O›Malley PG, Hartzell JD. Leadership training in graduate medical education: A systematic review. J Grad Med Educ 2018;10(2):134–48. doi: 10.4300/JGME-D-17-00194.1. [Accessed 20 November 2020].
  61. Manski-Nankervis JE, Sturgiss EA, Liaw ST, Spurling GK, Mazza D. General practice research: An investment to improve the health of all Australians. Med J Aust 2020;212(9):398–400.e1. doi: 10.5694/mja2.50589. [Accessed 20 November 2020].
  62. Mesko B, Győrffy Z, Kollár J. Digital literacy in the medical curriculum: A course with social media tools and gamification. JMIR Med Educ 2015;1(2):e6. doi: 10.2196/mededu.4411. [Accessed 20 November 2020].
  63. Sturgiss E, Haesler E, Anderson K. General practice trainees face practice ownership with fear. Aust Health Rev 2016;40(6):661–66. doi: 10.1071/AH15153. [Accessed 20 November 2020].
  64. Tekian A, Hodges BD, Roberts TE, Schuwirth L, Norcini J. Assessing competencies using milestones along the way. Med Teach 2015;37(4):399–402. doi: 10.3109/0142159X.2014.993954. [Accessed 20 November 2020].
  65. Reed S, Shell R, Kassis K, et al. Applying adult learning practices in medical education. Curr Probl Paediatr Adolesc Health Care 2014:44(6);170–81. doi: 10.1016/j.cppeds.2014.01.008. [Accessed 20 November 2020].
  66. World Organization of National Colleges, Academies and Academic Associations of General Practitioners/Family Physicians (WONCA). Bangkok: WONCA, 2020. Available at www.globalfamilydoctor.com [Accessed 20 November 2020]. [Accessed 20 November 2020].
  67. United Nations Economic, Scientific and Cultural Organization. Prototype of a national curriculum. Paris: UNESCO, 2017 [Accessed 2 December 2020].
  68. Schneiderhan J, Guetterman TC, Dobson M, 2019, Curriculum development: A how to primer. Fam Med Community Health 7(2):e000046. doi: 10.1136/fmch-2018-000046. [Accessed 2 December 2020].
This event attracts CPD points and can be self recorded

Did you know you can now log your CPD with a click of a button?

Create Quick log