This guide defines comprehensive Australian general practice and outlines its underlying principles. It is relevant to:
- GPs in training (GPiT)
- General Practice Experience Pathway candidates
- general practices and other potential training sites interested in becoming accredited for general practice training
- training providers
- medical recruitment agencies
- rural workforce agencies
- Primary Health Networks
- Department of Health and Aged Care
- Local Health Networks/Districts
- General Practice Supervisors Australia
- General Practice Registrars Australia.
This guide should be used to support decisions, including those regarding:
- Candidates on the GPE Pathway:
- approval of training positions and sites
- eligibility to sit Fellowship exams
- eligibility for Fellowship
- Assessment of recency and context of practice for participants on the Practice Experience Program – Specialist Stream (PEP Specialist)
Definition and principles
The RACGP definition of comprehensive Australian general practice is founded on the RACGP educational framework (guiding principles 1, 2, 3, 8 and 9).
Comprehensive Australian general practice is defined as practice that:
- prioritises holistic, clinical person-centred healthcare
- is ethical and socially responsible
- addresses the health needs of all people living in Australia in an equitable way
- meets the needs of underserved populations, including those living in rural and remote regions and Aboriginal and Torres Strait Islander peoples
- covers the full breadth of patient demographics, case presentations and the diverse settings where GPs work.
- is evidence based and is not limited to a specific interest or subset of general practice.
The GP’s responsibility
Specialist GPs are clinically responsible for:
- preventing illness
- promoting health
- intervening early for those at risk
- managing acute, chronic and complex conditions
- providing end-of-life care
- providing healthcare to all Australians.
General practice settings
General practice occurs primarily in the practice setting, but also in patients’ homes, health services, outreach clinics, other community facilities, and at times in hospitals. General practice is delivered face to face in a clinic or via a range of modalities, such as telehealth. As such, general practice settings:
- provide continuity of care in primary health through an ongoing doctor–patient relationship over time
- are primarily non-referral based
- are not limited to a specific discipline
- ensure medical care is provided and clinically managed by GPs
- provide comprehensive care, including preventive, acute and chronic care
- coordinate care according to the needs of the patient, their family and the community
- deliver person-centred healthcare.
Relation to general practice competencies
The competencies expected of an Australian GP are outlined in the Progressive capability profile of the general practitioner. These competencies can only be achieved by working in comprehensive general practice.
Time required for GPiT to gain practice experience
A GPiT must spend sufficient time working in comprehensive Australian general practice to gain experience working with a diverse range of patients, presentations and practice processes, and providing continuity of care.
For GPiT working in general practice part time, the time requirements are:
- 14.5-hour minimum working week, over a minimum of two days per week, of which a minimum of 10.5 hours must be face-to-face, rostered, patient consultation time undertaking general practice activities
- work periods must be at least three consecutive hours
- placements must be a minimum of one month in any one practice
- program time calculations based on hours worked are defined by RACGP-approved program policies.
Relevance to Vocational Training Pathway
The Vocational Training Pathway provides training in comprehensive Australian general practice in accredited training sites.
Training sites where GPiT are placed for their general practice training terms (GPT1, 2 and 3) undergo a rigorous accreditation process to ensure they provide training in comprehensive Australian general practice.
At various points during training, GPiT will train in contexts that don’t comply with the principles outlined in this guide. These contexts are approved on the basis that they provide opportunities for GPiT to further develop specific skills relevant to general practice. They include:
- hospital training
- extended skills training
- advanced rural skills training (ARST)
- special training environments (generally ADF registrars).
Relevance to GPE and Specialist pathways
Applicants to the GPE or Specialist pathways must apply to have their general practice experience assessed in accordance with the definition of comprehensive Australian general practice.
Approved Medical Deputising Services
Participants in the Practice Experience Program – Standard Stream can access a Medicare provider number to work in an Approved Medical Deputising Service (AMDS). However, provider number approval doesn’t necessarily indicate that the workplace is considered to offer comprehensive Australian general practice. We consider that an AMDS does not provide sufficient scope to meet the definition of comprehensive Australia general practice.
After we have assessed an applicant’s general practice experience, we rate the scope of that experience according to the Assessment of General Practice Experience Policy, General Practice Experience Pathway - Exam Eligibility Policy and the Practice Experience Program Specialist Stream Assessment of Recency Policy to assign a comparability rating. This provides one of the following ratings of how comparable the experience is to comprehensive Australian general practice:
- 100% comparable
- 85%, 75% or 50% comparable
- not comparable (eg hospital experience).
Health systems are compared to the scope of general practice service to the Australian community.
Please note that experience in overseas general practice can’t be considered 100% comparable because it was not in an Australian context.
The following table outlines the assessment considerations for each level of comparability and considerations for the different pathways. Please refer to the FAQs for examples of how the comparability ratings may apply.
Attributes of the post
- Undertaken in a comparable overseas health system
- Covered the full range of demographics and presentations expected to be seen in comprehensive Australian general practice
|No cap on the amount of time that will be recognised
May contribute to a substantially comparable recency assessment for PEP Specialist
The post covered the full range of presentations expected to be seen in comprehensive Australian general practice, but either:
- took place in a different health system
- took place in an Australian or comparable overseas health system, but with either:
- a reduced scope of practice due to a slightly reduced demographic of patients
- a slightly reduced range of presentations
A cap of 3.5 years FTE on the amount of time that will be recognised
May contribute to a partially comparable recency assessment for PEP Specialist
The post had one or more of the following attributes:
- a limited demographic of patients
- a limited range of presentations
- limited management options
A cap of 2.5 years FTE on the amount of time that will be recognised
Not comparable for PEP Specialist
* This rating is most applicable to PEP Specialist Stream applicants.
Approved Medical Deputising Service (AMDS)
An AMDS is a service or organisation, approved by the Department of Health, to arrange and facilitate the provision of deputised medical services to patients at the request of their regular general practitioner in the after-hours period when they are not available. Deputising services can be provided at a clinic and/or in the home of a patient. (From Department of Health and Aged Care, AMDS Program Guidelines.)
Can you give me an example of a 100%-comparable post?
- Dr A has experience working in a long-established general practice in a large rural town, seeing the full age range of patients from neonates to the elderly, and slightly more female than male patients (60/40). Dr A has an interest in intrapartum care and performs deliveries at the local hospital. Dr A also visits the local aged care facility half a day per week and offers home visits.
- Dr B works in a capital city in an inner metropolitan general practice near a university. The practice sees a large number of students who may be transient, but approximately 60% of patients are long term. Dr B sees the full spectrum of ages and presentations.
- Dr C works in a small rural town three days per week and spends one day per week in a satellite clinic in a smaller town 100 km away. The satellite clinic shares staff and medical records with the main practice. The next nearest practice is 200 km away. Dr C is responsible for acute care, chronic disease management and preventive health.
Can you give me an example of an 85%-comparable post?
Posts that are assessed as 85% comparable are outside Australia, but provide comprehensive care in a similar health system.
- Dr D has worked in general practice in a large group practice in rural Ireland, seeing patients of all ages and genders. Dr D managed acute care, chronic disease management and preventive care.
- Dr E trained in a large city practice in a busy UK city. The practice sees patients of all ages and with all presentations. The practice is well supported by the local hospital when required.
- Dr F works in a rural general practice in Kenya and sees the full scope of practice. However, the health system and disease patterns are different to Australian general practice.
Can you give me an example of a 75%-comparable post?
- Dr G works in a large general practice in New Zealand and has a particular interest in men’s health. Dr G works with five female colleagues and hence sees few female patients (20%), most of whom are children. Although the health system is similar to Australia’s, the reduced demographics means the post is only considered 75% comparable.
- Dr H works in a metropolitan Australian general practice. Dr H has chosen to work mainly in acute care in the practice, but for several sessions a week sees long-term patients for their ongoing health needs.
Can you give me an example of a 50%-comparable post?
- Dr I is working full time in a women’s health clinic in an urban general practice with four other female doctors. She sees only female patients, and no children or men. She provides general health services, including preventive care, family planning, antenatal care and cosmetic procedures.
- Dr J has worked part time as a medical officer at a remote mining site for the past six years. Dr J sees mainly acute presentations and provides some preventive care, but does not see any children.
- Dr K works in a home-visiting AMDS.
Can you give me an example of a non-comparable post?
- Dr L is working as a hospital resident in a regional city and has taken weekend shifts at a drive-through COVID-19 swabbing clinic. Dr L works 18 hours per week across the two days.
This work experience is assessed as not comparable because it is not general practice. There is no continuity, no chronic disease management and no patient assessment. While GPs may work in these types of settings, not all work done by GPs is necessarily general practice.
- Dr M migrated to Australia from Iraq three years ago and has since completed full-time hospital resident terms in gastroenterology, psychiatry, orthopaedics and emergency medicine in a capital city hospital.
This post is assessed as not comparable because it is not general practice. While the skills gained will be transferable to general practice, the work itself is not general practice.
- Dr N works 20 hours per week doing immigration medicals in an Australian capital city.
This work experience is assessed as not comparable because it is not general practice. Dr N doesn’t take clinical responsibility for the ongoing care of the applicants.
Are Approved Medical Deputising Services considered comprehensive Australian general practice?
Approved Medical Deputising Services (AMDS) don't meet the definition of comprehensive Australian general practice because they don’t provide continuing, comprehensive whole-person care. An AMDS may be assessed as 75% or 50% comparable or not comparable, depending on the location, context and scope of practice.