Registrar Support and Remediation Policy


Policy

1. Purpose

The purpose of this policy is to define the principles underpinning the support available to enable Registrars to achieve their training outcomes and satisfy the requirements of Fellowship.

2. Scope

2.1 This policy applies to:

    1. All Registrars enrolled in the:

      1. Australian General Practice Training (AGPT) program, and

      2. Fellowship Support Program (FSP), and

      3. RACGP Staff.

2.2 This policy also provides specific support for the following cohorts:

    1. Aboriginal and Torres Strait Islander Registrars,

    2. Culturally and linguistically diverse Registrars, and

    3. Australian Defence Force (ADF) Registrars.

2.3 This policy is to be read in conjunction with the relevant Registrar handbooks and staff training manuals.

    1. For a holistic understanding of the support the RACGP provides to Registrars, this policy can be read in conjunction with the GPiT Safety and Wellbeing Policy and GPiT Equity and Inclusion Policy.

2.4 This policy replaces the previous Registrar Remediation Policy and relevant regional training organisation policies and will come into effect on the start date of the first term of the Training Program in 2023. For the avoidance of doubt, to the extent that there is any inconsistency between the previous policies and this policy, the terms of this policy apply.

3. General principles

3.1 The RACGP aims to provide individualised support to Registrars to enable their growth and reflection and progress towards Fellowship.

3.2 The intent of the Remediation process is to provide timely additional educational resources and Program Time to support the Registrar’s progress towards Fellowship.

3.3 The RACGP support and Remediation processes are based on:

    1. adequate information obtained from multiple sources,

    2. respectful and prompt communication with all involved,

    3. impartiality, and

    4. tailored management plans delivered in a supportive learning environment.

3.4 To improve workforce and training equity, the RACGP offers specific support to:

    1. Aboriginal and Torres Strait Islander Registrars through enhanced access to general practice training and rural generalist training via prevocational and vocational pipelines and additional support throughout their Training Program,

    2. Culturally and linguistically diverse and international medical graduate Registrars, by orientating them to Comprehensive Australian General Practice and supporting their training and work in that context, and

    3. ADF Registrars through additional support throughout the AGPT program.

4. Register support

4.1 The RACGP provides various support throughout all Training Programs, including: 

    1. individualised training advice and planning, 

    2. pastoral care,

    3. focused learning interventions, and

    4. Fellowship Exam support. 

4.2 Support for Aboriginal and Torres Strait Islander Registrars

    1. The RACGP provides additional individualised support to Aboriginal and Torres Strait Islander Registrars throughout their Training Program. This includes:

      1. priority training placements,

      2. training advocacy,

      3. cultural support,

      4. tailored supervision and practice support, and

      5. Fellowship Exam support

        1. the RACGP Aboriginal and Torres Strait Islander Health faculty provides support to Aboriginal and Torres Strait Islander Fellowship exam candidates to assist in the successful completion of all exam components.

        2. support provided by the RACGP Aboriginal and Torres Strait Islander Health faculty is not subject to any future reconsiderations and appeals. The information and/or support provided is intended to supplement the Registrar’s own study and exam preparation plan and does not infer an exam pass guarantee at future exam attempt(s).

    4.3 Support for culturally and linguistically diverse and international medical graduate Registrars

      1. The RACGP provides additional support to culturally and linguistically diverse and international medical graduate Registrars throughout their Training Program. This includes, but is not limited to:

        1. communication skills training,

        2. orientation to Good medical practice: A code of conduct for doctors in Australia, and

        3. individualised support as needed.

    4.4 Support for Australian Defence Force Registrars

      1. For the AGPT Program, the RACGP has a national ADF team that enables flexibility in the Training Program required by this mobile cohort of registrars.

      2. The RACGP ADF Team provides full support for the ADF Registrar’s training. A medical educator with a specific ADF portfolio ensures connection with the local and regional teams who provide support and training management.

      3. ADF-specific training support includes:

        1. orientation,

        2. mentorship,

        3. training planning managed by the RACGP ADF Team,

        4. ADF transfers between geographical regions, and

        5. overseas Extended Skills Training posts.

      4. Policy exemptions specific to ADF Registrars:

        1. ADF Registrars do not have to meet the training location obligations detailed in the Training Program Requirements Policy if their ADF location obligations clash with rural or outer metropolitan requirements. 

        2. The RACGP ADF Team will work with the Registrar to find a suitable location to sit Fellowship exams, including remote access if necessary, excluding for the Clinical Competency Exam.  

        3. Registrars can prospectively apply to have a deployment recognised as a Special Training Environment. If a deployment is not recognised as a Special Training Environment, the time spent on deployment will be administered as Category 3 leave as per the Leave Policy

    5. Additional educational interventions

    5.1 The RACGP follows the principles detailed in A guide to managing performance concerns in general practice registrars to manage the need for additional educational interventions. These include:

      1. early identification of Registrars requiring additional assistance to progress through training,

      2. assistance and additional support,

      3. educational interventions, for example, focused learning interventions (FLIs),

      4. Remediation, and

      5. early exit from training.

5.2 Educational interventions are managed by the RACGP together with the Training Site and Supervisor.

5.3 The RACGP follows documented processes for early identification and management of Registrars with performance concerns who may require additional training and support.

5.4 Remediation

    1. Remediation is available to support Registrars:

      1. who have not shown sufficient improvement despite the implementation of FLIs, and

      2. when the RACGP assesses a Remediation term may enable the Registrar to reach an appropriate standard.

    2. The RACGP has the discretion to place the Registrar on Category 2 leave while investigating the requirements for Remediation in the event that the RACGP identifies a risk to the safety of the practice community or the Registrar, should the Registrar continue training.

    3. Registrars approved for support under this policy may be subject to the Withdrawal Policy (Category 4 – Withdrawal based on compliance with Education and Training Requirements) if:

      1. they fail or refuse to complete the agreed management plan, or

      2. the RACGP determines the Registrar has unsuccessfully completed the management plan.

6. Amendment of this policy

The Censor-in-Chief (CiC) may, without the consent of the RACGP Board, make Minor, Moderate and Consequential Amendments to this policy at any time. 

If the CiC makes amendments, they must advise the RACGP Board of those amendments as soon as practicable. 

The RACGP Board may make amendments to this policy at any time.

7. Responsibilities

7.1 Censor-in-Chief

  1. Approving Minor Amendments
  2. Approving Moderate Amendments
  3. Approving Consequential Amendments

7.2 RACGP

  1. Supporting the Registrar
  2. Providing Educational Interventions
  3. Assessing the Registrar for remediation terms
  4. Determining the outcome of a remediation term

7.3 RACGP Board

  1. Approving Major Amendments

7.4 National Remediation Unit

  1. Approving applications for remediation

7.5 Registrars

  1. Accessing the supports available to them
  2. Undertaking a prescribed remediation term
  3. Appealing the RACGP’s decision following a program of remediation, should they be dissatisfied.

 

8. Glossary

 

8.1 Business Day

A day when both the RACGP national and relevant regional offices are operating.

8.2 Comprehensive Australian General Practice

As defined in the Comprehensive Australian general practice guidance document.

8.3 Consequential Amendment

An amendment that requires urgent implementation as a necessary result of an amendment to another policy or process.

8.4 Education and Training Requirements

The mandatory components of the Registrar’s RACGP-Approved Program as defined in the relevant Registrar handbook.

8.5 Extended Skills Training

A 26-calendar week (FTE) term undertaken to extend the depth and breadth of the Registrar’s skill base in an area relevant to general practice.

8.6 Fellowship Exams

The exams run by the RACGP to assess the Candidate’s competency for unsupervised general practice anywhere in Australia, including:

  1. Applied Knowledge Test (AKT),
  2. Key Feature Problem (KFP), and

Clinical Examination, which depending on the time of sitting, is the Objective Structured Clinical Exam (OSCE), Remote Clinical Exam (RCE) or Clinical Competency Exam (CCE).

8.7 Major Amendment

An amendment that materially changes the operation of the policy but is not otherwise a Minor or Moderate Amendment (ie a change to one major clause or policy review).

8.8 Minor Amendment

An amendment to style, to correct grammatical mistakes, change overall formatting, make updates that do not materially change meaning, or any other amendment, which in the opinion of the Censor-in-Chief, does not materially alter the operation of the policy. 

8.9 Moderate Amendments

An amendment that materially changes the operation of a policy by a limited amount (ie a change to one minor clause, or changes that have a limited impact on the outcome of the policy).

8.10 Program Time

The length of time required to complete an RACGP-Approved Program.

8.11 RACGP ADF Team

The RACGP Australian Defence Force (ADF) team has a national approach to supporting the management of ADF Registrars in the AGPT program.

8.12 RACGP Staff

Anyone who is an employee or contractor of the RACGP.

8.13 Registrar

The medical practitioner enrolled in the:

  1. Australian General Practice Training (AGPT) program, 
  2. Remote Vocational Training Scheme (RVTS), or
  3. Fellowship Support Program (FSP).

8.14 Remediation

The process by which the Registrar receives additional support requiring funding and suspension of Program Time in order to address performance concerns.

8.15 Special Training Environment (STE)

A placement offering a training opportunity with a limited case mix and different operational arrangements. Therefore, STEs do not meet accreditation standards for Australian Comprehensive General Practice. Registrars can be placed at an RACGP-approved STE for a maximum of six months.

8.16 Supervisor

An accredited general practitioner who is both a clinician and role model who takes responsibility for the education and training needs of the Registrar while in the practice.

8.17 Training Program

Either the:

  1. Australian General Practice Training (AGPT) program, or
  2. Fellowship Support Program (FSP).

8.18 Training Site

A health service accredited by the RACGP where the Registrar may undertake their general practice training. For AGPT Registrars, this excludes the mandatory hospital training time.

 

9. Related documents, legislation and policies

10. Policy review and currency

This policy will be reviewed every three years from the last approval date, or when there is a significant change in the intent of the policy. This policy remains valid and applicable notwithstanding if it is overdue for review.

 

Version history

Version

Date of effect

Amended by

 

The start date of the first term of the Training Program in 2023

Education Policy and Guidance Lead

Amendment details

  • We now include sections on how we support all Registrars on the AGPT Program and FSP and specific cohort information for Aboriginal and Torres Strait Islander, Culturally and Linguistically Diverse and ADF Registrars.
  • The Remediation section has been translated from a policy regarding funding application to the overarching requirements of Remediation

Policy owner:

RACGP Board

Approved by:

RACGP Board

Approved on:

23/06/2022

Next review due:

06/2025

 

 

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