Vocational Training Pathway – Requirements for Fellowship


Policy

1. Purpose

1.1 The purpose of this policy is to describe the requirements for registrars in the Vocational Training Pathway to be admitted to Fellowship of the Royal Australian College of General Practitioners (FRACGP).

1.2 Context

Upon admission to Fellowship, the RACGP formally recognises that a medical practitioner is competent for unsupervised general practice anywhere in Australia. In the interest of upholding public health and safety, this policy ensures that registrars on the Vocational Training Pathway have satisfied all educational, experience, assessment, professional and ethical, and administrative requirements prior to admission to FRACGP. In turn, this policy ensures that general practitioners who have been admitted to FRACGP are of good repute.

2. Scope

2.1 This policy applies to registrars in the Australian General Practice Training (AGPT) Program and the Remote Vocational Training Scheme (RVTS).

2.2 This policy is to be read in conjunction with the Fit and Proper Fellow Policy and the GP in Training Membership Guidance Document.

2.3 This policy replaces the previous Vocational Training Pathway – Requirements for Fellowship Policy and will come into effect as of 11 October 2021. For the avoidance of doubt, to the extent that there is any inconsistency between the previous policy and this policy, the terms of this policy apply.

3. Requirements for Fellowship

3.1 Registrars who believe they have met all requirements stipulated in this policy must first complete the Fellowship application form and submit this with all relevant documentation and supporting evidence to their Training Organisation.

  1. A registrar’s Training Organisation will provide advice on the relevant documentation and supporting evidence required.

3.2 After the Training Organisation has reviewed and approved the application, it is forwarded to the relevant RACGP faculty censor/s for review and approval.

3.3 For more information on applying for FRACGP, please refer to the Applying for Fellowship of the RACGP via the Vocational Training Pathway Guidance Document.

3.4 Education requirements:

Registrars must complete:

  1. A minimum of three years (full time equivalent) specialist general practice vocational training and all education requirements in either the AGPT Program or RVTS, which must include:
    1. A basic life support (BLS) course that meets the requirements detailed in the Basic Life Support and Advanced Life Support Guidance Document, completed within the 12 months prior to commencing their first general practice term,
    2. Training in advanced life support (ALS) that meets the requirements detailed in the Basic Life Support and Advanced Life Support Guidance Document, completed within the four years prior to applying for Fellowship, and
    3. Completion of the RACGP’s Aboriginal and Torres Strait Islander Health unit in the Curriculum for Australian General Practice.

Registrars may undertake specialist general practice vocational training on a full time or part time basis.

3.5 Experience requirements

Registrars must complete:

  1. A minimum of one year of hospital rotations post Postgraduate Year 1 (PGY1) or intern year. The hospital rotations (in combination with PGY1) must:
    1. Provide the registrar with adequate exposure to a range of clinical rotations relevant to the discipline of general practice that provide the opportunity to develop the breadth of skills outlined in the Curriculum for Australian General Practice.
    2. Be sufficient to demonstrate an understanding of safe practice, including the recognition and management of the seriously ill patient, prior to commencing in general practice terms. This must include adequate recent exposure (as per 3.5.ii) to the discipline of medicine, surgery, emergency medicine and paediatrics. For further information on fulfilling the required experience, see the Mandatory Hospital Term Requirements Guidance Document.
    3. Be sufficiently varied to ensure the registrar does not spend longer than 6 months in any one discipline.
    4. Be undertaken in an accredited hospital in Australia or New Zealand.
  2. If a rotation was undertaken more than five years prior to the start of GPT1, the registrar must submit evidence of competency maintenance to their Training Organisation who will consult with the relevant RACGP Censor for approval.
  3. A minimum of 18 months general practice experience in RACGP accredited general practice training posts under the guidance of a RACGP accredited supervisor.
  4. Six months extended skills training approved by the Training Organisation in accordance with the RACGP Standards for General Practice Training.
    1. Extended skills training can be undertaken as:
      1. a single post,
      2. a number of single posts completed sequentially, or
      3. a combination of posts, of which the total training time across all sites must meet the full time or part time requirements in clause 3.5.iv.c of this policy.
    2. Registrars can undertake extended skills training in a variety of non-general practice settings, including non-clinical settings. It is a requirement that at least 50 per cent of total hours worked within an extended skills term is clinical work. A registrar cannot use a concurrent GPT1-3 term to fulfil the 50% clinical requirement of an extended skills term, excepting formal academic terms.
    3. The total number of minimum weekly working hours for extended skills terms are the same as for other terms. This means that registrars must undertake full time terms over a minimum of four days per week within a minimum 38-hour working week, and part time terms over a minimum of two days per week within a minimum 14.5-hour working week.
    4. The exception to clause 3.5.iv.c is that the minimum number of hours for a clinical extended skills post which is not in general practice may be less than 14.5 hours per week (but at least 3.5hrs a week), provided it is done concurrently with another clinical post/s, which, combined, include a minimum of 10.5 hours per week of clinical, rostered, face-to-face patient contact time.
    5. Posts must be at least four consecutive calendar weeks in duration.
    6. Registrars must not undertake non-clinical extended skills posts prior to completion of GP terms 1 and 2 without prospective approval from the relevant censor.
    7. Registrars wanting to undertake a non-clinical component of the extended skills term must submit a prospective learning plan with expected outcomes mapped against the Curriculum for Australian General Practice to their Training Organisation for approval.
  5. Training experience that involves a diversity of patient presentations in relation to age, gender, socioeconomic status, and cultural and linguistic backgrounds.
  6. Training experience which involves exposure to at least two different general practice supervisors and two different general practice management systems. For further guidance, please refer to A Guide to Managing Practice Diversity.

3.6 Assessment requirements

Registrars must:

  1. Pass the RACGP Fellowship Exams within their period of candidature in the AGPT Program or RVTS. Candidates must pass the Applied Knowledge Test (AKT) and Key Feature Problem (KFP) as a prerequisite to undertaking the Clinical Examination.
    1. The RACGP may permit registrars who are enrolled in an examination but leave the AGPT Program or RVTS prior to sitting the examination to undertake the examination provided they meet the eligibility requirements detailed in the Vocational Training Pathway – Examination Eligibility Policy.
  2. Pass all three examination segments within six semesters over three years from the first exam attempt (not including periods of approved leave) in line with the Fellowship Exam Attempts Policy.

3.7 Professional and ethical requirements

The RACGP reserves the right to withhold awarding an applicant FRACGP if the RACGP reasonably considers the relevant applicant:

  1. Engages in conduct which would attract sanctions under clause 27 of RACGP’s Constitution.
  2. Is unsuitable to be awarded Fellowship of the RACGP in accordance with the RACGP’s Fit and Proper Fellow Policy.
  3. Has restrictions, conditions, suspensions and/or undertakings on their current medical registration that prevent them from undertaking unsupervised general practice.

3.8 Administrative requirements

Registrars must:

  1. Hold current Australian medical registration at all times while on the Vocational Training Pathway. Registrars must promptly disclose any:
    1. Restrictions, conditions, suspensions and/or undertakings on or changes to their medical registration; and
    2. Regulatory authority activity, whether in Australia or otherwise, that:
      1. has led or may lead to a restriction, condition, suspension and/or undertaking on practice
      2. has led to an adverse finding for the medical practitioner, or forms part of an ongoing investigation.
  2. Registrars must disclose changes to their medical registration via email to education@racgp.org.au as any such restrictions could delay progression to the awarding of Fellowship.
  3. Failure to disclose details regarding medical registration outlined in this subclause will be handled as per the Academic Misconduct Policy.
  4. Be a financial RACGP member from the time of joining the Vocational Training Pathway and throughout their candidature. Further details on how this requirement can be met are available in the GP in Training Membership Guidance Document.
  5. Apply for Fellowship within three years of successful completion of the three examinations in clause 3.6.i, and within one year of completion of all pathway requirements.

4. Changing Fellowship Pathway

4.1 GPs in Training (GPiT) can only be enrolled in one Fellowship pathway at a time. If a GPiT seeks to participate in a different Fellowship pathway, they must resign their candidature in the current pathway and apply for entry into the alternative pathway. If a change in pathway is accepted, the GPiT must then meet all of the requirements of the new pathway to be awarded FRACGP.

5. Admission to Fellowship of the RACGP

The decision to admit a doctor to FRACGP is held by the Censor in Chief under delegation from the RACGP Board.

Reconsideration

5.1 If a GPiT believes that the RACGP has made an incorrect decision regarding their attainment of, or eligibility for Fellowship, they may apply for reconsideration in line with the RACGP Reconsiderations and Appeals Policy.

  1. GPiT must submit an application for reconsideration to the RACGP within ten national office business days of the date of the original decision.

6. Amendment of this Policy

The CIC may, without the consent of the Board, make Minor, Moderate and Extenuating Amendments to this policy at any time.

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

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

7. Responsibilities

RACGP Board

Responsible for awarding Fellowship to those candidates who have met all requirements as stipulated in this policy. Responsible for approval of policy and Major Amendments.

Censor-in-Chief

Responsible for:

  1. Ratifying the admission to Fellowship under delegation from the RACGP Board, and
  2. Approval of Minor, Moderate or Extenuating Amendments to the policy by delegation of the RACGP Board.

Registrars

Responsible for providing all relevant documentation and supporting evidence regarding their eligibility for Fellowship to their Training Organisation and the RACGP.

Training Organisation

Responsible for reviewing registrars’ applications for Fellowship and forward to the relevant Censor for approval

RACGP State Faculties / Faculty Censors

Responsible for reviewing and approve registrars’ applications for Fellowship.

8. Glossary

Accredited hospital

A hospital accredited by the Postgraduate Medical Education Councils.

Advanced Life Support (ALS)

See the Basic Life Support and Advanced Life Support Guidance Document.

Basic Life Support (BLS)

See the Basic Life Support and Advanced Life Support Guidance Document.

Clinical Work

Involves a doctor having direct contact with, and responsibility for, the assessment and management of patients.

Comprehensive Australian general practice

  1. Continuity of care that is person centred, comprehensive and coordinated; focusing on the whole person, and all presenting symptoms
  2. Health promotion and illness prevention services that are based on patient need and the best available evidence
  3. 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
  4. Community-based general practice undertaken in Australia. 

This is an abridged definition distilled from the Competency profile of the Australian general practitioner at the point of Fellowship.

Extended skills training

A six-month term undertaken for the purpose of extending the depth and breadth of the Registrar’s skill base in areas relevant to primary medical care.

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.

GP in Training (GPiT)

A medical practitioner enrolled in any RACGP Approved Program before gaining Fellowship, of which there are two types;

  1. Registrars, who are currently enrolled in the Australian General Practice Training (AGPT) or Remote Vocational Training Scheme (RVTS) programs, and
  2. Participants, who are currently enrolled in the Practice Experience Program (PEP) Standard and Specialist Streams.

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.

RACGP Fellowship Examinations

Includes:

  1. Applied Knowledge Test (AKT),
  2. Key Feature Problem (KFP), and
  3. 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)

Registrar

A medical practitioner who is enrolled in the Vocational Training Pathway.

9. Related Documents, Legislation and Policies

Guidance

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

2

11/10/2021

Policy Advisor, Strategy and Development

Amendment details

  • Clarified extended skills posts need to meet full time or part time requirements and do not necessarily have to be undertaken concurrently in clause 3.5.iv.
  • Clarified the RACGP may deem a participant unsuitable for Fellowship of the RACGP if they have restrictions, conditions, suspensions and/or undertakings on their medical registration that prevent them from undertaking unsupervised general practice in clause 3.7.iii
  • Nomenclature review

Policy owner:

Board

Approved by:

Council of Censors

Approved on:

17/09/21

Next Review Due:

10/24

   

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