Practice Experience Program – Extenuating and Unforeseen Circumstances Guidelines


Introduction

During the Practice Experience Program (PEP), participants may experience extenuating and unforeseen circumstances that temporarily prevent a participant from:

  1. Participating in the program, including work as a medical practitioner in the capacity of a General Practitioner at a minimum of 14.5 hours over 2 days a week;
  2. Participating in self-directed study of PEP learning units, at a minimum of approximately 6-8 hours per week; or
  3. Continuing to work in the allocated training organisation region;
  4. Meeting an assessment submission deadline or presenting for a clinical assessment, such as completion of core units or a workplace based assessment.

In the event of such circumstances, participants may apply for:

  1. Leave from the educational or exam candidacy phases of their program;
  2. Extension to the educational or exam candidacy phases of their program;
  3. Transfer between training organisations (TO);
  4. Variation to provider number location conditions in order to receive medical treatment not available in an MMM2-7 location.

If a participant does not inform the RACGP of leave taken during either phase of the program owing to extenuating and unforeseen circumstances, the RACGP will not be able to accurately assess timely fulfilment of the Satisfactory Completion Framework requirements, and this may impact on a participant’s ongoing access to a provider number under the PEP, including for the purposes of extension.

Participants should inform the RACGP as soon as possible after an extenuating and unforeseen circumstance arises, via the Change in Circumstances form, accessible via the PEP portal.

This document provides guidance to participants as to the kind of circumstances which may qualify under the definition of extenuating and unforeseen circumstances and the kind of evidence which will be required in order for the RACGP to make an accurate assessment of the circumstances. The evidence submitted will be used to determine a participant’s need in relation to leave, extension and transfer and the leave, extension and transfer options available for a participant experiencing such circumstances.

Note: This document does not cover leave for legislative purposes, such as parental leave, or personal/recreational leave for other reasons not covered under the definitions of extenuating and unforeseen circumstances in the Practice Experience Program Leave and Extensions Policy and the Practice Experience Program Transfer Policy.

What are extenuating and unforeseen circumstances?

Extenuating and unforeseen circumstances are defined in the Practice Experience Program Leave and Extensions Policy and the Practice Experience Program Transfer Policy as “circumstances which were unforeseen, outside the participant’s control and which can be shown to have a direct and significant impact on the participant’s ability to complete the PEP requirements.”

Participants may apply for consideration of extenuating and unforeseen circumstances in the event that either the participant themselves or an immediate family member experiences any of the circumstances outlined below.

Note: In the event that the participant is unable to personally communicate with the RACGP, third party requests for recognition of extenuating circumstances may be made.

In such cases, evidence must be provided as to why the participant cannot personally make the request, and where possible consent must be given for third party communication to take place.

Examples of extenuating and unforeseen circumstances

Extenuating and unforeseen circumstances may include, but are not limited to:

1. Ill health

  • Life-threatening illness;
  • Serious Accident;
  • Hospitalisation;
  • Illness that could become life-threatening if not treated correctly;
  • Diagnosed mental health condition;
  • Unforeseen pregnancy complications;
  • A chronic illness or disabling condition that if not treated correctly will prevent the person from performing their normal occupation (Minimum 14.5 hours over 2 days a week of General practice);
  • Inability to receive necessary medical care in an MMM 2-7 location (for example, radiotherapy treatment or treatment requiring frequent attendance at a MMM1 medical facility).

2. Acute adverse life circumstances

  • Bereavement;
  • Significant personal / family circumstances being encountered by the participant (for example, a spouse’s mandatory employment move);
  • Unusually severe stress in response to work and life circumstances which prevent the participant from working the minimum part time program requirements of 14.5 hours over two days per week;
  • Illness of a first degree family member.

3. Employment conditions

  • Loss of AHPRA registration;
  • AHPRA process difficulty or delay in obtaining registration due to circumstances beyond the participant's control, such as Health Complaints Commissioner (HCC) proceedings;
  • Loss of employment due to factors beyond the participant’s control (such as a practice closing down);
  • Loss of employment due to factors relating to the participant’s work environment (such as dispute with staff, patient complaint, undergoing investigation by AHPRA);
  • Loss of Supervisor, where the participant is subject to AHPRA supervision levels 1-3;
  • Change in immigration status affecting ability to continue working.

4. Other

Unique life events include but are not limited to:

  • Emergency or disaster;
  • Pandemic;
  • Attendance at legal proceedings;
  • Australian Defence Force (ADF) deployment or other military service.

NoteThe examples above are not exhaustive, and any circumstances submitted to the RACGP will be assessed on a case by case basis.

If a participant experiences any circumstances not listed in this document which nevertheless have a significant impact on their ability to continue with program requirements, they should submit a Change in Circumstances form so that the most appropriate support and guidance can be offered by the RACGP.

Submitting evidence

This section provides guidance regarding the kind of evidence required to demonstrate the presence and impact of extenuating and unforeseen circumstances for the purposes of application for leave, extensions or transfer.

The RACGP recognises that the nature of some extenuating and unforeseen circumstances will prevent the participant from timely application for consideration. However, where possible, application should be made within one calendar month of the circumstances arising.

Categories of extenuating circumstance

1. Ill health

In the event that the participant or a first degree relative experiences ill health, including ill mental health, evidence submitted should include the following information (where appropriate):

  1. Details of diagnosis
    • Where possible, this should be a recognisable diagnosis using objective criteria. Where the issue pertains to mental health, diagnosis should reference a tool such as the DSM.
    • Date of first diagnosis.
  2. Impact of diagnosis
    • How long the relevant specialist has been providing treatment;
    • Frequency of treatment (for example, how many visits in the past month). Visits less frequent than once every two months will not necessarily be considered sufficiently impactful without the presence of other mitigating factors.
    • The reasons why treatment prevents the participant from meeting the program’s minimum part time requirements in a MMM 2-7 location to – for example, in the event that specialist services such as radiotherapy are required;
    • Expected duration of illness;
    • The estimated time for which the participant will be unable to meet the program’s minimum part time requirements;

Evidence should also be provided regarding:

  1. Where the participant is providing care (for applications where the participant is providing care to a first degree relative);
  2. Level of care provided (for applications where the participant is providing care to a first degree relative) – for example, the number of visits to medical services the relative requires, the number of hours spent providing care, and the forms of care and assistance provided;
  3. Where medical services required for treatment of the participant or the first degree relative are situated; applications for recognition of extenuating and unforeseen circumstances on the grounds of medical treatment will generally only be considered where the individual requires medical care that:
    • The participant provides a letter of support or other evidence (from a GP or other relevant specialist) that the treatment is not available or suitable in their current location
    • Is required more than once every two months. Treatments less frequent than once every two months will not necessarily be considered sufficiently impactful without the presence of other mitigating factors.
    • The treatment is generally recognised as appropriate for the medical condition.

2. Acute adverse life circumstances

Accepted evidence includes, but is not limited to:

  • Statutory declaration
  • Death certificate
  • Evidence of mandatory employment relocation
  • Specialist letter of support or letter from a GP, including evidence of the participant’s involvement in treatment

3. Employment conditions

Accepted evidence includes, but is not limited to:

  • AHPRA communications
  • Statutory declaration
  • Letter from place of work indicating circumstances
  • Evidence from Immigration detailing change in circumstances

4. Other

Accepted evidence includes, but is not limited to:

  • Evidence of residence in an area affected by natural disaster, emergency or pandemic
  • Evidence of employment with an organisation managing fallout of natural disaster, emergency or pandemic
  • Court summons/subpoena evidence
  • Letter from ADF confirming deployment

Medical practitioner requirements

Medical evidence may include a detailed letter of support from a GP or relevant specialist.

However, to ensure that objective medical information relating to a participant’s circumstance is submitted, the RACGP requires independent medical evidence from a health professional who is free from any potential conflicts of interest. This means that all evidence submitted by a medical practitioner must meet the following requirements to be recognised:

  • The practitioner is not related to the participant/first degree relative
  • The practitioner does not have other personal connection to or relationship with the participant/first degree relative
  • The practitioner does not work within the participant’s current general practice workplace and is not a prospective employer
  • The practitioner is an AHPRA-registered GP or treating specialist directly involved with the diagnosis or treatment of the participant/first degree relative

Application outcomes

On receipt of an application for leave, extension or transfer for extenuating and unforeseen circumstances, the RACGP will assess the circumstances against the criteria outlined in this document. The RACGP may request additional information to supplement the application.

  • Following an application for leave or extension, the participant should receive an outcome within 10 national office business days of receipt of the application
  • Following an application for transfer, the participant should receive an outcome within 16 weeks of receipt of the application. This is owing to the need to apply for a provider number for the new place of employment, in line with the Practice Experience Program Transfer Policy.

1. Application approved

The duration of the leave or extension, or the terms of the training organisation transfer, is determined on the grounds of the severity of the medical condition, the supporting evidence provided, the stage of the PEP program, and the impact on the participant’s AHPRA registration.

Participants are not permitted to undertake work using their PEP provider number during any periods of leave, including during leave for extenuating and unforeseen circumstances, and it is expected that no other clinical work will be undertaken. Access to the PEP educational units via the LMS will also be deactivated during periods of leave.

  1. Impact of leave on learning units

While access to the LMS is suspended during periods of leave, the RACGP understands that participants who are readying to return from periods of leave may wish to recommence units before they start clinical work, to reduce workload or to prepare for re-entry to practice.

To facilitate this, participants have the option to return to the program on a clinical break – completing educational units without clinical work for up to three months. For more information on the clinical break, please see the Practice Experience Program Leave and Extensions Policy.

During the clinical break, there will be elements of some units requiring in-practice or clinical work; these units can be completed once the participant has returned to the full program (i.e. clinical and educational components undertaken concurrently. The workplace based assessment for the term in which the clinical break falls will be postponed until the participant returns to work clinically.

2. Application denied

If the participant’s conditions are determined not to fit the criteria for extenuating and unforeseen circumstances, other options may be offered, such as:

  • Taking personal leave (i.e. leave for any other reason not included in the definition of extenuating and unforeseen circumstances in this document and relevant policy);
  • Taking parental leave (where applicable) instead of extenuating and unforeseen circumstances leave;
  • Reduction in working hours (subject to the participant continuing to meet the program’s minimum part time requirements;
  • Deferral of entry to the program (if circumstances arose prior to entry).

Circumstances not considered grounds for recognition

Participants are advised that the following are not on their own considered sufficient grounds for recognition of extenuating and unforeseen circumstances:

1. General

  • Circumstances for which appropriate adjustments have already been made by the RACGP
  • Circumstances stated to be unforeseen that a reasonable person would view as foreseeable or preventable
  • The participant has previously been issued a SAPP provider number (the participant would be required to apply for the RACGP’s extenuating circumstances recognition and be reassessed)

2. Employment

  • Loss of employment that extends beyond three month permitted clinical break
  • Disputes with employer or working conditions
  • Working hours in excess of 38 hours whilst on the PEP program, leading to an inability to complete workload

3. Medical

  • Self-certified illness or medical circumstances
  • A claim for recognition of a medical condition that relies on evidence that does not relate to the time when the illness or condition occurred, or was documented more than six months prior to application
  • A long-term health condition where there is no evidence of a sudden worsening
  • A minor illness that would not normally lead to a responsible and reasonable employed person to take sick leave
  • An uncomplicated pregnancy

4. Personal

  • Holidays, including getting married, attendances at marriages, festivals and other personal events
  • Divorce or relationship breakdown
  • Financial hardship
  • General stress or emotional isolation which is not associated with a diagnosed mental health condition. When a participant is experiencing some degree of stress while on the program, it is recommended that they reduce their working hours (provided that they continue to work the 14.5 hour minimum) to ensure adequate time can be given to other responsibilities and self-care.

5. Geographical

  • Geographic isolation in MMM 2-7 location
  • Request for metropolitan placement based on religion, ethnicity or language skills
  • Request for a metropolitan location to access specific services (e.g. child care, educational needs for children etc.)


Employee Assistance Program

The RACGP recognises that doctors experiencing extenuating and unforeseen circumstances may feel distressed and overwhelmed. To assist its members, the RACGP offers access to its counselling and support service, the Employee Assistance Program (EAP). EAP is a free and confidential service available to all members and their immediate family members, where they can access professional advice to help cope with life stressors that can impact on wellbeing, work, and psychological health.

For more information or to access the service please call 1300 361 008.


Disclaimer

Declaring physical or psychological impairment to the RACGP is confidential unless it is determined necessary to disclose to AHPRA under the RACGP’s mandatory notification obligations.


Enquiries

 1800 626 901

 racgpeducation@racgp.org.au