1. Practice Experience Program – Specialist Stream Substantially Comparable Requirements for Fellowship Policy
1.1 Policy number: CO-E-0037.0
1.2 Category: Education
1.3 Approval date: September 2019
1.4 Revision due date: September 2022
1.5 Unit responsible: Education Services
2. Policy declaration
Substantially comparable participants enrolled in the Practice Experience Program (PEP) Specialist Stream must meet the requirements detailed in this policy to be awarded Fellowship of the RACGP.
3. Background, objectives and scope
- The PEP Specialist Stream is the pathway to Fellowship of the RACGP available to specialist international medical graduates (SIMGs). Previous iterations of this pathway include:
- the Specialist Pathway Program (SPP), which ran from 2010 to 2018, and categorised SIMGs as Category 1, 2 or 3, or not comparable; and
- the Specialist Recognition Program (SRP), which superseded the SPP from 2018 to 2019.
- From 1 September 2019, the Specialist Pathway to Fellowship will fall under the PEP as a specialist stream. This adjustment supports the removal of Fellowship ad eudem gradum (FAEG) to ensure a robust and more uniform approach to the assessment of SIMGs. From this time, SIMGs will be required to work under supervision under limited or provisional registration from the Medical Board of Australia. The RACGP will issue PEP provider numbers to eligible SIMGs to permit access to A1 Medicare rebates.
This policy aims to describe the requirements for Fellowship for substantially comparable participants of the PEP Specialist Stream.
- This policy applies to substantially comparable SIMGs enrolled in the PEP Specialist Stream, and outlines the requirements these participants must meet in order to obtain Fellowship.
- This policy and associated policies will supersede the existing SRP as from 1 September 2019.
- Participants enrolled in the SPP or SRP before 31 August 2019 will continue their candidacy under policies in existence at the time of their enrolment in the SRP or SPP.
For the purposes of this policy:
- Comparable/comparability means the extent to which an SIMG’s recency, continuity of practice, continual professional development, assessment, training, qualifications and clinical experience are assessed as equivalent to an Australian-trained specialist general practitioner at the point of Fellowship.
- Substantially comparable means the participant has been assessed as suitable to undertake the full scope of practice, taking full responsibility for all patients, with limited oversight of their practice by a supervisor (peer review) and reach comparability within 12 months’ full time equivalent (FTE) practice, with a maximum time on the program of 24 months if working part time.
- Comprehensive Australian general practice means:
- continuity of care that is person centred, comprehensive and coordinated; focusing on the whole person, and all presenting symptoms;
- health promotion and illness prevention services that are based on patient need and the best available evidence;
- the diagnosis, treatment and management of the full range of undifferentiated conditions in a diverse range of individuals, families and communities not limited by practice intention or business focus; and
- community-based general practice undertaken in Australia.
- Full time general practice experience comprises a 38-hour minimum working week, over a minimum of four days per week, of which a minimum of 27 hours must be in face-to-face, rostered, patient consultation time undertaking general practice activities. Work periods of less than three consecutive hours, or of less than one month in any one practice, will not be considered. Hours worked beyond this definition of full time will not be considered.
- Part time general practice experience is calculated pro-rata against the definition of full time general practice experience. Part time general practice must comprise a 14.5-hour minimum working week, over a minimum of two days per week, of which a minimum of 10.5 hours must be in face-to-face, rostered, patient consultation time undertaking general practice activities. Work periods of less than three consecutive hours, or of less than one month in any one practice, will not be considered.
- Participant means a medical practitioner who has been accepted into the PEP Specialist Stream.
- Multi Source Feedback (MSF) consists of three components – a colleague feedback assessment tool, a patient assessment tool, and a reflective task.
- PEP Specialist Stream means the route to Fellowship available to SIMGs who have been assessed as substantially or partially comparable to an Australian-trained specialist general practitioner at the point of Fellowship.
- Program Agreement means the RACGP agreement signed by the participant preceding official entry into the PEP.
- Supervision/supervised practice means supervision in line with the principles of supervision and supervised practice, based upon the prescribed Medical Board of Australia Guidelines – Supervised Practice of International Medical Graduates.
- Workplace Based Assessment (WBA) provides a framework for evaluating a doctor’s performance and progress in those areas of practice best assessed in the context of the workplace. The aim is to provide evidence that the SIMG is competent for unsupervised practice in Australia. The WBA program will include MSF, clinical assessment, a learning unit reflection task, and supervisor reports.
5. Requirements for Fellowship
5.1 Experience requirements
- commence work in an Australian comprehensive general practice within six calendar months of signing the Program Agreement; and
- complete at least six months’ full time equivalent (FTE) experience in comprehensive Australian general practice under limited or provisional supervision.
5.2 Education requirements
- provide evidence of a Basic Life Support (BLS) course completed within the 12 calendar months prior to applying for Fellowship. The requirements are detailed in the RACGP’s Basic and Advanced Life Support Guidance Document;
- provide evidence of training in the early management of trauma and advanced life support (ALS) completed within the four years prior to applying for Fellowship. The requirements are detailed in the RACGP’s Basic and Advanced Life Support Guidance Document;
- satisfactorily complete a Workplace Based Assessment (WBA) program, to be undertaken any time after the participant has worked three months’ FTE in comprehensive general practice.
Participants must repeat the WBA if it is not satisfactorily completed on the first attempt. No subsidisation will be available for participants undertaking a second WBA. A maximum of two attempts at the WBA is permitted, and those who do not satisfactorily complete the WBA after the maximum number of attempts will be reassessed as partially comparable. They must then meet the requirements detailed in the Practice Experience Program – Specialist Stream Partially Comparable Requirements for Fellowship Policy to be awarded Fellowship of the RACGP. This includes completion of the RACGP’s Applied Knowledge Test (AKT), 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).
5.3 Adminsitrative requirements
- Hold current Australian medical registration from the date of commencing work in Australian general practice and throughout their candidature. Participants must promptly disclose all details of any past or present:
- Restrictions on or changes to their medical registration; and
- Regulatory authority activity, whether in Australia or otherwise, that
- has led or may lead to a restriction on practice; or
- has led to an adverse finding for the medical practitioner, or forms part of an ongoing investigation.
Participants with restrictions on their medical registration or any other regulatory activity may not be granted Fellowship of the RACGP. Failure to disclose 5.5.a.i or ii will be handled as per the Academic Misconduct Policy.
- Maintain financial membership of the RACGP from the time of entering the PEP Specialist Stream until the award of their Fellowship certificate or their withdrawal from the program;
- Achieve Fellowship within 12 months' FTE of commencing employment, with a maximum time on the program of 24 months if working part time; and
- Apply for Fellowship within one year of successful completion of all of the requirements of the program.
Participants who fail to meet the requirements of the PEP Specialist Stream or who fail to maintain adequate progression may be withdrawn from the program.
5.4 Professional and ethical requirements
The RACGP reserves the right to withhold awarding an applicant Fellowship of the RACGP, if the RACGP reasonably considers the relevant applicant:
- would be at risk of breaching clause 27 of the RACGP’s Constitution; or
- is generally unsuitable to hold Fellowship of the RACGP as detailed in the Fit and Proper Fellow Policy.
- RACGP will audit compliance with the Clause 5 requirements six months’ FTE after the candidate has commenced work.
- Participants who have complied with the requirements as per clause 6a above will receive a certificate of Fellowship and be invited to a graduation ceremony.
- Participants who have not complied with the requirements as per clause 6a above may be allowed six further calendar months to become compliant, at the discretion of RACGP. If after this period of time the Clause 5 requirements have not been met, candidate non-compliance will be reported to the Medical Board of Australia as per the requirements of the Medical Board of Australia Registration Standard: Specialist Registration.
If a participant believes that a decision regarding their attainment of, or eligibility for Fellowship has been made incorrectly, they may apply for reconsideration in line with the RACGP Reconsiderations and Appeals Policy.
An application for reconsideration must be submitted to the RACGP within ten national office business days of the date of the original decision.
8. Related policies, documents and legislation
All related policies are available here.
All related guidance documents are available here.
9. Administrative procedures
9.1 Access to published policy
This policy will be available via the RACGP website as detailed in clause 8.
9.2 Promulgation of published policy
Relevant staff members will be provided communications explaining the function and role of this policy.
9.3 Review of this policy
This policy will have a review cycle of three years.