ADF guide

While we trust that you will find this guide useful, we also encourage you to contact your RACGP regional ADF team for any question you may have during your training. Your regional ADF team is comprised of a Training Coordinator (TC) and Medical Educator (ME), who can support you and provide tailored advice in many areas, including:

• orientation,
• mentorship,
• training planning,
• transfer management, and
• recognition of deployments, exercises, and courses as training time.

The AGPT program comprises one year (FTE) of clinical hospital experience as part of your hospital training term, followed by two years (FTE) of core vocational training (Figure 1).

Figure 1: AGPT Program for ADF registrars

The two years of core vocational training are broken down into four terms, each lasting 26 weeks (FTE):

• three general practice terms (GPT1, 2 and 3), and
• one extended skills training (EST) term.

While on the program, you must meet the same program requirements as non-ADF registrars, as per the Training Program Requirements Policy.

ADF registrars often practice in Garrison Health Centres, as detailed in Figure 2. These environments present excellent training opportunities but offer limited case mix and different operational arrangements. Garrison Health Centres do not meet the RACGP training requirements for comprehensive Australian general practice, and are accredited for GP training as Special Training Environments (STE).

Figure 2 provides an overview of all ADF Garrison Health Centres nationally. Not all locations are currently accredited for training. For more information about the accreditation process for ADF Garrison Health Centres as STE, and to access relevant site and supervisor accreditation application forms, please visit the RACGP website at Accreditation of placements for ADF registrars.

Registrars must complete GPT1 and GPT2 in a comprehensive civilian general practice prior to training in an ADF Garrison Health Centre.

Any placement in an STE must be approved by the relevant Censor before you start the placement. To seek approval, please discuss with your TC, who will liaise with the National Lead Medical Educator - ADF as required.

Note: As Butterworth is located outside Australia, it is not accredited as an STE. Placements at this location must approved via an ADF overseas extended skills training placement application.

Figure 2: Garrison Health Centres

As part of your core vocational training, you must complete three general practice training terms (GPT 1, 2 and 3).

The course covers: 

• GPT1 and GPT2 (12 months FTE in total) must be completed in a civilian general practice that meets the RACGP Standards for general practice training and is not a classified as a Special Training Environment. This is to ensure you gain experience to the full depth and breadth of general practice. As with the hospital training, we strongly recommend that you focus on gaining paediatric, adolescent, antenatal, geriatric, chronic disease and multimorbidity experiences where possible, as these clinical exposures will be limited in further stages of training due to your ADF commitments.

Please note that terms undertaken in civilian general practice must meet the minimum part-time training requirements below:

• GPT3 (six months FTE) may be undertaken as a composite term with placements in both a civilian general practice and/or at Garrison Health Centres accredited as STE.

Civilian general practice placements

You must meet the same training and educational requirements as non-ADF registrars while completing your civilian placements, however there are a few points of difference:

• While you complete your civilian placement, you are not employed by the practice. You remain a full-time employee of your ADF service branch (Army, Navy, or Air Force) and must receive acknowledgement from your ADF service that they agree to your civilian placement.

• A secondment agreement must exist between you, the practice and the ADF service. The secondment agreement will outline the pay recovery arrangement, as well as the responsibilities and expectations to be met by you, the practice and the ADF. This involves the practice making a payment in line with the National Terms and Conditions for the Employment of Registrars (NTCER) to the ADF for the standard hours you worked at the practice. The secondment agreement must be in place before the civilian placement starts.

  Contacts for secondment agreements
  Navy	Directorate of Navy Health, dnh.correspondence@defence.gov.au
  Air Force	Via Headquarters Health Services Wing, Clinical Governance and Assurance Cell ambhqhsw.clingov@defence.gov.au
  Army	Directorate of Army Health, armyhealth@defence.gov.au

   

• Ordinary working hours for an ADF registrar are set as below, and include consultation hours, administration, in-practice and out-of-practice teaching hours:
  • Navy and Army: 37.5 hours per week, Monday to Friday, from 7.00am to 8.00pm.
  • Air Force: 38 hours per week, Monday to Friday, from 7.00am to 8.00pm.

• Work that you complete outside of your usual ADF hours is payable to you by the practice. This requires written permission from your ADF service (i.e. via an approved ‘AE107 Request to undertake civilian employment or voluntary activities in off duty hours’). A separate employment contract for this additional work must also be arranged between you and the practice, and must comply with the NTCER.
• ADF registrars do not receive additional payment or percentages of billings for work undertaken during ordinary working hours.
• At the end of each month in civilian practice, you and the practice manager must complete a placement record to allow the ADF service to raise an invoice to the practice for cost recovery. This will be in alignment with the NTCER rates of pay.
• Civilian practices do not pay sick leave, annual leave, or superannuation to ADF registrars. Cost recovery does not occur while the registrar is away from the practice completing compulsory RACGP training (e.g. workshops) or approved study leave.
• The training location requirements and commitments applicable to non-ADF registrars are met for ADF registrars by their contribution to the Garrison Health service provision.
• The practice diversity requirement (commonly known as the 2-practice requirement) is met by ADF registrars working in a Garrison Health Centre in conjunction with their civilian placement – this means that a single civilian practice can support a registrar throughout training if all parties agree.
• ADF registrars may be placed directly by their RACGP regions, and do not contribute to practice placement distribution training caps, as per the Placement Process – Guide for practices.

As part of your core vocational training, you must complete one term (six months FTE) of EST. The aim of the EST term is to give you an opportunity to further your knowledge and skills in an area of specific interest or in need of development.

You may undertake up to six months (FTE) of EST in a Garrison Health Centre provided it has received STE accreditation.

ADF medical courses that have been pre-approved by the RACGP (see Appendix 1), and other individual courses and training approved on a case-by-case basis, may contribute towards GP and EST training terms as below:

• GPT1, 2 and 3: up to a maximum limit of two weeks in each term.
• EST: up to a maximum limit of 13 weeks.

To apply to have a course recognised as GP or EST term time, you must submit the ADF Placements, Courses and Deployments form. Please note that pre-approval is required before you start the course. Final approval will be obtained upon submission of documented evidence of satisfactory course completion.

Deployments and exercises conducted in Australia may contribute towards the EST term, provided the deployment or exercise is appropriately supervised and demonstrates development of skills and learning relevant to general practice. Expected learning outcomes must be provided in the application and signed off by a supervisor at the completion of the placement.

You can apply to have up to 26 weeks of deployment or exercise within Australia recognised as EST.

To apply to have a deployment or exercise in Australia counted towards the EST term, you must submit the ADF Placements, Courses and Deployments form prior to commencing the deployment/exercise.

If urgent deployment has occurred, your regional ADF team will liaise with the National Lead Medical Educator – ADF to initiate the recognition process.

Once a training term is completed, retrospective recognition of deployments/exercises towards that training term can't be granted.

There may be occasions during GPT3 or the EST term where you are required to move to another ADF health centre. These placements may be recognised as training time provided the Garrison Health Centre is accredited as STE.

Placement within your region

To apply to have a placement to a Garrison Health Centre within your region counted towards GPT3 or EST, please submit the ADF Placements, Courses and Deployments form. Approval must be sought prior to the change of site.

Placement outside of your region

To apply to have a placement to a Garrison Health Centre outside of your region counted towards GPT3 or EST, please submit the ADF Placements, Courses and Deployments form. Approval must be sought prior to the change of site.

In some cases, if your placement extends beyond a set number of weeks, it may need to be managed as a transfer between regions. Your TC will let you know if this is the case and assist you with the process.

You can apply to have up to 26 weeks of overseas deployment recognised as EST.

You should discuss your plans to complete your EST as an overseas deployment with your regional ADF team to ensure you meet any other training obligations while training outside of Australia.

Please read the ADF overseas extended skills training placement application and guidefor more information about the application process. Your application must be accompanied by a detailed learning plan. Applications will be reviewed on a case-by-case basis by the relevant RACGP censor.

Applications for EST as overseas deployment must be submitted to the RACGP prospectively. We understand there are circumstances where you may be deployed prior to submitting the application. Where this is the case, please provide the reasons in your application so you can seek an exemption to apply retrospectively.

Within three months of completing your overseas EST placement, you must complete the ADF overseas extended skills placement summary report. This report will be also reviewed by the relevant RACGP censor, who will check that educational and supervisory requirements have been met, and confirm whether the placement is approved as EST time.

Deployments on Naval ships are considered to be overseas deployments.

The AME Course is conducted over four weeks and addresses the clinical aspects and practical implications of transporting patients by air, and the technical aspects of aircraft preparation for AME use. The course covers theory and practical phases for the C-17, C-27 and C-130 and may be run at RAAF Amberley and RAAF Richmond. 

The course covers: 

• aviation physiology 
• clinical aspects of AME 
• organisational aspects of AME 
• AME aircraft operations 
• AME equipment 
• AME missions 
• patient evacuation.

There are ten summative assessments required for successful completion of the AME course – seven knowledge and three performance assessments.  

The AVMO course is conducted over four and a half weeks and prepares ADF Medical Officers to work as Aviation Medical Officers (AVMO). ADF AVMO are required to assess and manage the health of ADF aircrew and other aviation personnel, provide advice to ADF commanders on aviation medicine and how this impacts military capability, and provide medical support to ADF flying operations. The course is provided to military, civilian and international students. In addition to meeting ADF capability requirements, completion of the AVMO course qualifies the ADF MO as a Designated Aviation Medical Examiner (DAME) in accordance with the Australian Civil Aviation Safety Authority requirements.

The course covers:

• introduction to aerospace medicine
• aerospace physiology and environment
• clinical aerospace medicine
• operational aerospace medicine
• human factors and accident response.

Students on the AVMO course undertake practical training in symptoms of hypoxia, spatial disorientation, water survival and air traffic control tower experience.

EMST is a three-day* intensive course in the management of injury victims in the first 1–2 hours following injury. It aims to train ADF Medical officers in the knowledge and skills to care for personnel in acute, life-threatening emergencies.

The course covers:

• theory
• practical management
• treatment priorities
• care of severe trauma patients.

The course is conducted by the Royal Australian College of Surgeons using a combination of civilian and ADF instructors (accredited by RACS).

Formative assessments include a pre-course multiple-choice question (MCQ) test and practical assessments during the course. Summative assessments include a summative theory assessment (MCQ) and a practical assessment at the end of the course. 

*The Royal Australian College of Surgeons EMST course is over two days. ADF members complete an additional day of training (combining practical skills and theory) to contextualise EMST to the ADF operational environment.

The HOBC course is conducted over sixteen days and designed to provide the foundation skills and knowledge to command, plan and provide health support functions to operations.

The learning objectives of this course include:

• explaining the Health Corps foundation knowledge and organisational structures within Defence
• developing an understanding of Health Corps training continuum
• demonstrating an understanding of clinical governance
• demonstrating an understanding of medical administration
• demonstrating command, lead, and manage skills
• developing an understanding of Joint Health Capability
• developing an understanding of operational and strategic health.

The MOIC course covers the attributes (skills, knowledge, attitudes and behaviours) required to understand the command, leadership, and management responsibilities of a military medical officer.

The learning objectives of this course include:

• describing the role of the Royal Australian Army Medical Corps (RAAMC) and health service in Defence
• understanding the military medical officer’s responsibilities for subordinates
• understanding the military medical officer’s responsibilities for their personal career and professional development.
• understanding field health care
• understand Garrison Health care
• providing advice to Commanders
• identifying common musculoskeletal conditions and treatments in Defence
• managing disease and non-battle casualties
• understanding specific mechanisms of injury with military medicine
• managing mental health issues and conditions of military significance
• understanding ethical dimensions of health care in the military environment
• Tactical Combat Casualty Care - Medical Personnel.

Training will occur via off-the-job training primarily through instructor-led delivery using a method or combination of methods, such as presentations, lectures, forums, and group discussions.

The MOUM course is conducted over ten days and provides the ADF MO with an understanding of the range of potential medical problems faced by divers. Considerable emphasis is placed on the diving medical and the contraindications to diving, together with the pathophysiology, diagnosis and management of the more common diving-related illnesses. Although designed to meet ADF capability requirements, it also qualifies the ADF MO to undertake dive medical examinations for recreation and commercial purposes. 

The course covers:

• how the laws of physics apply to diving 
• how the physical properties of diving affect human physiology 
• diving equipment 
• barotrauma, its prevention and treatment 
• problems associated with the use of air, oxygen, heliox and nitrox breathing gases 
• decompression illness, its pathophysiology, clinical presentation and management 
• how to perform a recreational and occupational diving medical examination 
• requirements of a therapeutic recompression chamber and its life support systems 
• deep diving 
• hypothermia and its clinical management 
• diving tables and dive computers 
• dangerous marine animals and appropriate clinical management 
• diving accidents and how to prevent them.

During the course students are also introduced to clinical hyperbaric medicine and submarine medicine. 

The course also provides an update on current resuscitation

The RWAME course is a five-day theory/practical training series. The course covers aviation medicine general principles, assessment of patients in context of principles of aviation medicine, retrieval team management, procedures around and inside aircraft, communication before/during/after missions.

The learning objectives of this course include:

• Conducting RWAME operations
• Preparing for a RWAME
• Communicating effectively during a RWAME
• Loading, securing and unloading a casualty on a RW aircraft
• Providing casualty care during a RWAME
• Completing post mission activities following a RWAME.