The registrar
Registrar eligibility
Registrars interested in undertaking a remotely supervised term should meet the following criteria:
- GPT2+ with the appropriate skill level, competence and experience to work in the chosen location; GPT1 registrars may be considered in some circumstances if they have significant prior experience and robust support
- willingness to work remotely in a team environment within the constraints of the particular location
- attributes such as awareness of personal limitations, the ability to accept and use feedback and good communication skills, which will be important for the success of the remote supervision process
- ability and willingness to use IT resources to enable remote support.
The Remote supervision registrar requirements document outlines the registrar requirements in more detail.
Registrar selection: CRSPP interview
Purpose
The registrar CRSPP interview is designed to assess the registrar’s flexibility, cultural awareness, teamwork skills, willingness to learn and ability to accept and implement feedback. It is not expected that the registrar will have detailed knowledge of the context of the potential placement location because it is unlikely that they will be familiar with it.
During the interview, a series of case scenarios relevant to the context of the training site will be used to help explore areas that may require skill development, including cultural understanding and attitudes, clinical expertise and readiness to work with a team in a remote location.
The interview will review the registrar’s current clinical skills and those required for the new location, the thought processes behind their decision making in the scenarios, their personal resourcefulness, their insight into their own knowledge and skill gaps and how they ask for help. It will also identify areas that may need some upskilling before their placement.
The registrar CRSPP interview is not an examination about clinical skills, but more a discussion about the context of the placement and the attitudes and skills needed to work there. The scenarios may appear challenging, but they are designed to look particularly for the registrar’s approach to these issues. There will also be an opportunity to consider assessments of previous registrar placements, particularly in ensuring resilience and initiative. The aim is to ensure that the registrar is suitable for the planned placement.
The interview should not be seen as a barrier, but rather as an opportunity to identify and address gaps in the registrar’s skills.
Interview
The interview panel is made up of three interviewers: an RACGP medical educator, the remote supervisor (if known) and a senior member of the onsite supervision team.
General questions for the registrar include a discussion of the registrar’s strengths and weaknesses, anticipated challenges and how they will manage them and areas they may requiring upskilling in prior to the placement.
There are nine scenarios that are basic stems that will need to be contextualised to the training site. Not all will be used. Issues addressed in the scenarios include:
- local health infrastructure and resources for issues that may more commonly occur locally
- cultural awareness and appropriateness
- ethical and legal implications and boundary issues in a small community
- awareness and ability to address mental health, social issues, drug-seeking triage and emergency skills
- resourcefulness and problem solving
- ability to accept feedback
- insight into gaps and asking for help appropriately
- dealing with uncertainty, safety netting and follow up
- managing issues with other staff.
Please refer to the Registrar CRSPP interview guide for examples of scenarios to be adapted to the local situation and context.
Interview scenarios are not confidential. Prior to the interview, these scenarios will be adapted and contextualised to be relevant to the training location by the remote supervisor or training site representative. This could occur in discussion with the interview panel immediately before the interview.
During the interview each panel member will document their notes in the Registrar CRSPP interview outcomes document.
Outcomes
Following the registrar interview, the panel will convene to make a recommendation on the outcome of the CRSPP. This will include a review of the registrar’s CV, previous workplace-based assessments and other information from previous placements. Recommendations could include:
- upskilling before the placement (eg emergency skills, palliative care, drug and alcohol, mental health, practical or procedural skills)
- a ‘call for help’ list tailored to the registrar in this placement, where the registrar needs to discuss cases on the list with the supervisor, either at the time of the patient presentation or at the end of the day, until the supervisor is confident the registrar can ask for assistance ‘as needed’
- the registrar needs more face-to-face supervision before they are ready for remote supervision
- facilitating a site visit for the registrar, if necessary, prior to committing to the placement
- the registrar is not appropriate for this training site at this time and will require another placement location (the registrar may be encouraged to undertake a general practice placement under a normal supervision arrangement and reapply)
- the registrar needs to establish specific skill/knowledge during the orientation period while working with the supervisor onsite.
For those deemed appropriate, the process is concluded with starting to develop the Remote supervision placement plan and a contextualised ‘call for help’ list. The Remote supervision placement plan is developed to finalise the details of the placement for approval by the lead medical educator remote supervision and relevant state censor.
It is important to note that even if the registrar is successful and placed in the remotely supervised training site, the two-week orientation period when the remote supervisor is onsite with the registrar should be seen as a type of ‘probationary’ period to fully assess whether remote supervision is appropriate in this context (refer to Remote supervision orientation).