GPSA Chair Report – May 2024

Change not necessarily the only constant!

April 2024 has been a month of many significant days, extremes of celebration and tragedy, but there is one I would like to highlight in particular.

ANZAC Day is an opportunity to reflect on a great many things: sacrifice, courage, security, commitment, loss, solidarity, trauma… all having a lasting impact equally on loved ones and the community at large as on those who have contributed to our armed forces. GPSA is proud to support our peers who currently serve, those who have served, those who supervise ADF registrars, and those who care for our veterans and their families.

With Autumn in full gear now, May seems to be shaping up as a month of action for all of us in the supervision environment. Some of you will be completing mid-term reports for your registrars, others getting ready for the next round of placements, and hopefully we’re all keeping up with our professional development requirements too.

In my many travels and roles as a GP, I am repeatedly engaged in discussions about GPSA activities. This feedback from a supervisor peer who attended a webinar presented by Dr Simon Morgan and Dr Tim Chappell shows the impact our ongoing educational delivery has on our members:

Thank you both for a very engaging seminar! I watched it because I am a supervisor but benefitted from it as a GP. Tim, you had me at “dementor” and “chocolate”….! I absolutely love my job and listening to what you shared, Tim, it articulated the “why”. It was just good to hear again about the importance of being a good listener, being in your patient’s corner, not giving up on them…. and smiling! As is the case in many places, there is a high demand for services (where I work) and a long wait time and I have wondered if I should be more “matter of fact” and a more efficient problem solver so as to be able to see more patients. But I think that one would then miss out on those nuggets of history that come forth with time, and also the meaningful doctor-patient relationships that we can have in our line of work.

And these words from a registrar who had reached out in a time of difficulty shows the benefit of what GSPA’s focus on the “how” of supervision ultimately has on our trainees:

I am at a new practice now – it is amazing what a difference a supportive supervisor can make. Feeling settled and now actually can start to learn.

It is when we receive such feedback that I know our impact as supervisors goes well beyond supervision, and GPSA’s impact as the supervision peak truly is vital for the future of general practice.

GP training will continue to change, as will general practice. As part of this community of practice, we will have to evolve and keep up with the world around us, yet we can do so in the knowledge that the GSPA values shaped by the “why” and the “how” of supervision will remain a constant on which you can rely.

The other thing you can depend on is GPSA’s commitment to representing you faithfully in our stakeholder engagement, the future direction we are advocating for on your behalf, and in the priorities you share for the current review of the National Terms and Conditions for the Employment of Registrars (NTCER).

If you haven’t already done so, please take some time out to complete our National Survey for 2024. This is not an idle exercise. This really is your opportunity to influence future policy around a range of things including workforce, remuneration and recognition of supervision. The information we obtain from this survey helps us share the real issues at the coalface with policy makers and funders, emphasising what needs to change and what needs to stay the same. While this is of course the long term benefit, there’s a short-term one too! Completing “ENGAGE 2024 – Building a better future together” counts towards your CPD (RP) as an added bonus. This survey is open to everyone involved in GP training – supervisors, GPs, practice managers, practice nurses, and others who support learners in general practice.

For anyone who has been involved in registrar employment – terms, conditions, or contract oversight -, now is the time to help us maximise the opportunity to update this legally valid employment instrument. The inevitability of change applies in this area of GP training too, with other employment models being explored under the Single Employer Model pilots, but the NTCER remains relevant to the bulk of GPs-in-training, and we need your contribution to ensure its robustness and utility is maintained and possibly broadened to non-traditional contexts (i.e. beyond the employment of AGPT registrars). We’ve come up with a variety of ways for you to tell us what’s important, which key areas you would like addressed to ensure the next version of the NTCER is fit for purpose into the future. Let us know your views via the NTCER survey and/or by joining one of our member workshops or via email.

So until next month…

May the force be with you!

Dr Srishti Dutta
Chair

Date reviewed: 01 May 2024

Please note that while reasonable care is taken to provide accurate information at the time of creation, we frequently update content and links as needed. If you identify any inconsistencies or broken links, please let us know by email.

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“We really are building the future of general practice”
Dr Candice Baker, GP Supervisor and GPSA Board Director

Candice obtained fellowship as an Australian General Practitioner in 2015, then as a Canadian Family Physician in 2019. She has worked at a training practice in regional Victoria for 10 years.

This is where the seeds of passion for medical education were sown through supervision of medical students and registrars before becoming an accredited supervisor early in 2022.

How have you arrived at your GPSA role?
“I have a desire to contribute within general practice supervision, to try to ignite some change, and help support the profession.

“That desire has been born out of the environment that I trained in and therefore the same sort of environment that I want to create and promote in terms of general practice supervision. It stems back to when I did my training and that amazing environment, surrounded by my supervisors, and a culture of teaching and learning: where everyone was a teacher and a learner at the same time. I identified with these colleagues, and they were pivotal in shaping my desire to follow their lead.

I identified with these colleagues, and they were pivotal in shaping my desire to follow their lead”

“With regards to my role on the GPSA Board specifically, I think that’s probably a combination of my love of teaching with a hint of opportunity and a whole lot of luck – falling into things at the right time and the right place. Dr Madhu Tamilarasan, a GP Supervisor and former GPSA Director and friend, motivated me to engage actively with GPSA. Despite my hesitation about my suitability for the Board, Madhu encouraged me to throw my hat in the ring. She was a great inspiration to me.”

How have your various roles prepared you for your work with GPSA?
“The training environment I experienced enabled me to get involved in education in various forms. As a 2nd year registrar, I was involved in supervising medical students and I was also a Registrar Medical educator (RME) with my Victorian RTO.

“I also work for Monash University School of Rural Health and assist in the running of their general practice program for their Year 4 students. These roles were quite complementary to general practice supervision and allowed me to understand the breadth of supervision, and in fact, what it means to be a supervisor.

“And I’m currently a Supervisor Liaison Officer (SLO) which is a complementary role to everything in terms of advocating and works nicely with my GPSA Board role.
“It all seems to be a very natural progression for me, and I have just gone where the path has taken me.”

Do you see opportunities for GPSA’s education products internationally?
“I think there are opportunities for GPSA to expand to specific international markets where the core knowledge is the same throughout. For example, in looking at Canada where I spent some time during Covid, there were no major differences to Australia in terms of primary health care.

“In terms of SCENARIO, GPSA’s phone application, I think it’s really helpful and could be applied in other health care settings. Particularly for new supervisors, who maybe just haven’t quite figured out exactly how they want to structure their teaching sessions, or whether they’re stuck for what to cover at a particular stage in their learner’s journey.

“This application offers a form of convenience and a certain spontaneity that can be helpful. SCENARIO can flush out streams of deficiencies or things that maybe the learner needs to focus a bit more on. For example, was their respiratory knowledge as good as their cardiology knowledge; are they not as good at communication versus legal concepts.

“I think there is huge potential for growth within different areas of specialization, whether that’s obstetrics or emergency. I can see it being used much more widely and I’ve certainly found it useful and a fun thing to add to our teaching sessions with my registrars.”

What challenges are presently of greatest concern in the realm of supervision for our members that you’re aware of?
“I have three issues when I speak to supervisors that are top of mind:

  1. The sustainability of supervision – in the sense of the current apprenticeship model in general practice and what that looks like into the future.
  2. Appreciation of supervision is a big concern and, in particular, how supervisors are viewed In the wider scheme of things. With the transition of GP training back to the colleges, I think that has led to some under appreciation and undervaluing of the supervisors on the ground. There has been lots of new work and new assessments being introduced with limited consultation on the ground about how that would work in practice.
  3. Thirdly, remuneration is always a hot topic. I think we’re all aware that GP supervisors give way more than what most people would at the hourly rate they get paid. There seems to be this constant idea that supervisors can just do more, and that’s okay. Can we create a sustainable, high quality general practitioner at the end of training, if we don’t nourish the people that are nourishing them? We wouldn’t expect to have a bountiful garden full of vegetables if we didn’t actually take care of the soil. I think supervisors are the soil that helps grow our future workforce.”
  “I think supervisors are the soil that helps grow our future workforce.”
 

What solutions do you see that we offer to our members? What are we doing to help?
“GPSA is striving to lead from the front. I think our presence is more visible and the organisation is more prominent compared to perhaps 3-5 years ago.

“I believe we’re doing a great job advocating for those at the coalface and that’s partly because the Board of Directors are supervisors – we are the people we represent. We’ve got a firsthand idea of what it’s like to be on the ground and doing supervision work. That puts us in an excellent position to be able to advocate for change and be heard. We are very good at listening to our members and making sure that we sort of get a seat at every table to talk about issues that are important to general practice supervision.

“I firmly believe you can’t effect change if you’re not actually involved in the conversation. From that perspective, it’s been a successful couple of years in terms of having a seat at each table and being able to do that.”

Message to fellow supervisors
“My main message to fellow supervisors is that we value you. A while ago I was told by a colleague at Monash, “we really value what you do”. I suddenly thought, no one’s ever really said that to me. As supervisors, we really don’t get told that we are valued for what we do. Now I make a concerted effort when I catch up with my local supervisors to tell them that we really value having them as part of the team. And if there’s anything that we can do to make life a bit easier for them, then tell us. Acknowledging their indispensable role in general practice training is crucial. Without supervision and the dedicated work of supervisors on the ground, training simply wouldn’t be possible. We really are building the future of general practice and GPs in Australia.

We really are building the future of general practice and GPs in Australia.”

“Additionally, I really feel strongly about finding a way to further engage practices that are committed to education and training at a high level of quality. It’s important we come up with a set of standards for supervision that allow us to ensure that we are putting supervisors and registrars into supported practices, and that we know that trainees are going to get a good training experience. The GPCLE tool has a huge role to play in this work. It sets the standard of supervision and whether we’re meeting that bar as training organizations or training practices. This is an important focus over the next couple of years.”

Date reviewed: 24 April 2024

Please note that while reasonable care is taken to provide accurate information at the time of creation, we frequently update content and links as needed. If you identify any inconsistencies or broken links, please let us know by email.

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GPSA Chair Report – April 2024

Celebrating & Reflecting

March was certainly a month for celebrations and reflection – Harmony Day, International Women’s Day, Holi, St Patricks Day, Ramadan, World Compliment Day, International Day of Happiness, Lent and Easter….

Following the first meeting of the General Practice Training Advisory Committee (GPTAC) in Canberra at the tail end of the month, I can now share yet another reason for GPSA members to reflect and celebrate: the release of the AGPT Program National Report on the 2023 National Registrar Survey | Australian Government Department of Health and Aged Care.
For me, the key messages in this report reiterate the vital role the people at the coalface of GP training played in the successful transition to college-led training – and continue to play as the lifeblood of high quality primary care for the Australian community.

The satisfaction of registrars with our members has remained consistently high from 2017 to 2023. Indeed, the analysis by the Australian Council for Educational Research (ACER) of over 1000 open-ended responses in the 2023 survey shows that more than 92% of registrars attributed the best aspects of their training experience to:

  • their current workplace or practice;
  • supervisor and mentor support; and
  • the diversity of patient presentations.

This feedback reinforces the value of GPSA’s commitment to facilitating a supportive and well-structured clinical learning environment for tomorrow’s GP workforce – through our ever-expanding repository of educational resources, our virtual community of practice, the GPCLE quality improvement tool we are currently refining, our upcoming biennial review of the National Terms & Conditions for the Employment of Registrars (NTCER), and even the Memorandum of Understanding (MoU) recently signed between GPSA and our sister peak GPRA.

In all the many tables at which GPSA has a seat now, it is a true pleasure to highlight the role supervisors, practice managers and other members of training practices play in the success that we as a profession can claim today and into the future. My job as GPSA Chair is largely focused on advocating for you in your supervision of medical learners and trainees across the educational spectrum. I continually speak to both GP specialty colleges regarding topics our members flag as priorities, such as dual recognition of supervisor professional development and similar efficiencies to ensure minimisation of red tape and maximisation of well-being. To get this right though, we are reliant on your engagement and input.

To this end, you will soon receive an invitation to participate in the GPSA national survey – newly and aptly branded “ENGAGE”. I cannot stress strongly enough the importance of the information you provide through this data collection opportunity: the more you contribute to GPSA research such as this survey, the greater an investment we can make in your future growth and sustainability.

We will soon be launching into the NTCER review – which again is completely reliant on your input to ensure we represent your needs faithfully in this process. The NTCER remains a tool that provides protections for both training practices and registrars, and this year we are looking to enhance it and expand its application to non-traditional contexts such as vocational training pathways outside the AGPT. No doubt you have ideas about improvements at both a big picture and granular level, and we sincerely want to hear about these! Please submit your expression of interest here if you would like to be involved in workshopping the NTCER for 2025-26 with us.

Looking forward to working with you on the key activities lined up for April. Until then, as Yoda would say, “Pass on what you have learned”!

Dr Srishti Dutta
Chair

Date reviewed: 28 March 2024

Please note that while reasonable care is taken to provide accurate information at the time of creation, we frequently update content and links as needed. If you identify any inconsistencies or broken links, please let us know by email.

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Why get involved with GPSA? “Having lots of skin in the game,” says this high-flying GP

Dr Kate Manderson is a name associated broadly with Australian general practice and GP supervision yes, but also with aerospace medicine, corporate and clinical governance, advocacy and – above all else – family and community.

On the eve of the transition of GP training to the GP specialty Colleges, this experienced GP and practice principal decided it was time to contribute her vast skills and experience to ensuring quality and passion remained at the heart of clinical supervision for future GPs in-training.

So it was that this ADF-trained health professional, businesswoman, Principal Medical Officer of CASA, Senior Aviation Medical Officer of the  Royal Australian Navy, Graduate of the AICD, Medical Educator and past President and Chair of the Australasian Society of Aerospace Medicine (ASAM) came to be elected onto the Board of GPSA in October 2022.

Kate recently talked with our Communications Manager, Pauline Ingham, about her burning desire to get a better deal for Australian GP supervisors.

What do you think has brought you here to this role on the GPSA Board?

“After 25 years as a GP I have been inside the GP system for a long time and gained a lot of valuable experience.

“Like a lot of GPs, I have a lot of ‘skin in the game’, having worked as a GP, a Medical Educator and a Supervisor.

“I understand how it works, how it could be improved, and have seen some challenging times.”

Why GPSA?

“At a time when I couldn’t contribute to GP training at the coalface, I still wanted to contribute meaningfully.

“I saw the opportunity to use my experience and skills in clinical leadership and governance through the role on the GPSA Board… as a way to help our system, our supervisors and our trainees on a broader scale.”

She notes that she was encouraged and supported by colleagues who said, “Kate you can do this!” – and she decided the time was right.

“My experience in governance, company directorships and leadership came into play. Having an understanding of the importance of operating a viable and strong business, combined with my supervision experiences, enabled me to put myself forward and make a contribution to GPSA."

How have your various roles prepared you for your work with GPSA?

“My first role as a GP registrar prepared me by going through the system. I was privileged to train in Tasmania and on the whole had fabulous education, mentoring and training, working with pioneers and leaders who are still involved today. I learned from people who showed me how great it could be.

“My placement experience varied after that – some practices gave little support; however, it was still the early days of training, and often I was on my own. Some practices straddled the line between good and bad: offering great mentoring and supervision, but less structured education.

“So I had the opportunity to experience lots of different perspectives as a trainee as to what supervision looked like, could look like, and what it  actually should look like.”

How did that view of supervision you had as a trainee change when you started supervising?

“When I moved into the role as a Supervisor and had the opportunity to be on the other side of the table, I instantly realised how hard it can be to be a supervisor!

“I was so determined that there really is no excuse for being a poor supervisor, but the actual experience of doing the job for more than a decade, and having more than 50 trainees over the years, has led me to realise it’s not that simple at all.

“Supervisors deal with registrars of varying needs, and this requires a flexible system that can be very difficult to achieve.”

As a practice owner, what do you see as the challenges facing educating and training the next generation of GPs?

“I see two big challenges or barriers – adequate funding and adequate recognition.

“You want to be altruistic and you want to help somebody – vulnerable people and vulnerable communities – and you want to spend lots of time with patients. And that is beautiful, but you can’t do that if the practice closes because you can’t pay the wages.

“Let’s start with money, and we must talk about that. If your business goes bankrupt you can’t help anyone. It's a fundamental part of what I teach trainees, they have to understand the business of general practice."

So let’s talk about the money!

“It can seem unpleasant to raise, but thinking that money isn’t important is part of the reason we have ended up in this current situation.

“It is important – and there are some key barriers we need to address.

“To start with, the funding model of general practice is fit-for-purpose for 1975, but it is not fit-for-purpose for 2025, 2035, 2045… It hasn’t been fit-for-purpose for a very long time because everything has changed around us, just not this funding model. That is the biggest barrier.

“We are not funded as supervisors, and until that changes we will not have consistency in the quality of training placements… Which means appropriate funding is needed urgently for supervisors and training practices as well as the trainee.

“There is a vast difference between the funding for hospital-based supervisors with payment built into their contracts, and how GP supervisors do it: GP supervisors take a pay cut to teach!”

Any other barriers you’d like knocked down?

“The culture of general practice.

“The idea of #justagp – ‘Are you a specialist or just a GP?’ – is problematic.

“We need something much more powerful in recognition of the specialty of general practice.”

“I believe we must bring back the PGPPP so that everybody gets a turn in general practice – so they understand what it’s about.

“I also strongly believe that we need a name change, because everyone uses ‘GP’ whether they should or shouldn’t.”

“We need to identify our unique skill set, it’s got to be marketed, again back to the finances... We pay equivalently, we recognise the specialty equivalently, and everyone understands what the specialty does."

What challenges are presently of greatest concern in the realm of supervision for our members?

“My sense is that the biggest concern is ‘who’s going to take over when I am done?’

“We have members who are passionate, dedicated and committed in that role. And they are altruistic, self sacrificing, they are doing it without any money, without any recognition, because they want to and they think it’s important.

“Part of it is they are there for the future of the profession, part of it is they are there for the future of their practice. They are thinking, ‘If I am not supervising, we can’t get trainees; if we can’t get trainees, we can’t get succession planning and workforce’ and so on.

“I am living that experience right now. I am not currently supervising registrars in my practice so this equates to empty consulting rooms in my practice.

“People might say if we can’t get registrars then why not get Fellows. That is proving almost impossible in the current climate.” 

We need more women in supervision. How would you encourage women to pursue roles as supervisors? 

“Firstly, GPSA’s current Women in Supervision research is important because if it doesn’t get measured it doesn’t get fixed.

“Data is key and can be used strategically. Commonwealth Departments respond well to data, and politicians respond to real life stories. So you have to tackle any issues with submissions and data.

“With regards encouraging more women into supervision, I’ve already said that supervision is altruistic – you give of your time and your money. Women already have less money and less time, and we are asking them to have even less money and even less time. We have to fix that!

“Another factor is that historically women carry the greater burden of child care. If we have more, better, financially accessible child care for women in primary care, women would do more in primary care.

“If GPSA found a way to subsidise women volunteering to supervise with a cleaner? We’d be inundated! Essentially, childcare and financial recognition are the two things I think will get more women into supervision.”

“If we can adequately remunerate or financially recognise supervision overall, then this will no longer be yet another cut to women who are already being cut by the financial disparity we continue to endure. This would benefit everyone - not just women of course, but it would proportionately benefit women even more.”

What would you like to say to Australia’s supervisors?

“My message to Australian supervisors is to hang in there!

“You are special, you are doing amazing things. GPSA understands this and we’ve got your back. We’re going to do everything we can to make it better for you, so please hang in there while we do that.

“I’d also like to send a message to our trainees, our early Fellows and our new supervisors, and that is to please show up, please don’t expect everyone else to do it. It is a champion team, so show up, be brave, put yourselves out there.

“I urge you to support the industry leaders who are saying GPs have to charge privately and we have to charge our worth to make it so that we can afford to supervise in practices. Be brave, be there, show up and take it on!

“I am taken back to my time in the Navy when the mantra in an emergency or attack was to never leave the ship – the three step approach was ‘Fight, Move, Float’ and ‘we do not abandon ship!’

“So I say to my colleagues: we value you, we need you, don’t abandon the ship!”

Date reviewed: 28 March 2024

Please note that while reasonable care is taken to provide accurate information at the time of creation, we frequently update content and links as needed. If you identify any inconsistencies or broken links, please let us know by email.

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(Deputy) GPSA Chair Report – January 2024

~ In Dr Srishti Dutta’s absence, this report comes from GPSA’s Deputy Chair, Dr Frank Maldari ~

The ‘Santa Delusion’ and reading the fine print

What an interesting year we have had with the transition to College-led training. This has gone remarkably smoothly at the coalface – with only a few hiccups along the way, probably fewer than expected – which has a lot to do with the resilience of GPs and practice teams.

I would like to express from all at GPSA the enormous admiration we have for GP supervisors and training practices across the country. Given GPSA’s membership consists of more than 7,000 supervisors and 3,000+ honorary members, you represent arguably the largest unrecognised charitable organisation in Australia.

The peak representatives of GP supervision – the Supervisor Liaison Officers (SLOs) – met in Sydney on 8th December 2023. SLOs from all states and the NT participated in this Advisory Council meeting, representing RACGP (AGPT and FSP), ACRRM (AGPT, IP and RGTS) and RVTS. The passion and commitment to GP training was readily palpable and augurs well for the future of GP training if supervisors are appropriately supported. The main issues facing GP Training were discussed in an open and frank meeting with Georgina Van de Water representing RACGP as well as ACRRM’s President Dr Dan Halliday and General Manager of Education Services, Kyra Moss. The key issues identified by SLOs were clearly presented so that there was no question about what was important to GP training and the desired outcomes.

All SLOs were on the same page: we have significant headwinds in GP training, and future health workforce is dependent upon these being clearly addressed to avoid further negative impact to the already perilous state in which we find general practice currently.

The main issues addressed in no particular order were: supervisor support and professional development, bi-College collaboration and interface, registrar caps, Single Employer Model (SEM), the importance of data to drive progress, placement processes , and , specifically for RACGP, the new EASL requirements.

Supervisor professional development (SPD) – which has simultaneously experienced a significant reduction in support and a progressive increase in requirements – runs along the same lines as GP continuing professional development (CPD)… increasing requirements of a profession in a dire situation. The unintended consequences of reduced participation and loss of quality supervisors are readily apparent. There is only so much supervisors can give, and the tank is running on empty.

Placement process and registrar caps – a challenge for everyone but probably more so for registrars with many horror tales out there about practices receiving either unmanageable numbers of applications… or none; and registrars and practices having 1 week to arrange interviews and finalise offers. It is a mixed story across the country, NSW has obviously had the most experience of this process, and it seems to have become a game of ignore the rules or risk not retaining a registrar. Anecdotally, it seems to have failed on the two key metrics of placement in best quality training practices or highest area of need.

 

SEM – the devil is in the detail. This seems to be a very hot issue with state Health Ministers across the country champing at the bit to get a piece of the action. Terms like “cost neutrality” and “control” of primary care workforce carry a sense of foreboding and beg the questions: who is paying the piper? who is missing out? It cannot be cost neutral when an extra layer of bureaucracy is installed without extra funding. Fortunately, we had some reports from members and SLOs on the nature of contracts being proposed in NSW which really reinforced the view that the devil is in the detail. Please, read the fine print.

RACGP’s Early Assessment for Safety and Learning (EASL) – dramatic increase in demand put on supervisors for a payment of… $Zero. There was reassurance that we do not necessarily need to review every consultation for the full 4 weeks and can make a determination earlier, but no funding for those who do require closer monitoring. I must confess that I am a strong supporter of the concept and many supervisors do undertake this process both as educational and risk management for the practice. Indeed, studies undertaken by Drs Simon Morgan and Gerard Ingham do highlight the number of errors early term GP registrars make, many minor but still a significant number of serious errors. Ideally, in my humble opinion, we should be funded to review all consultations for the first three months of a GPT1 registrar term with time set aside for face-to-face discussion, random case analysis, etc. This would greatly improve competency and patient outcomes especially in the areas of rational investigation and prescribing practices. I would argue that if we did the study and looked at the data it would end up surprisingly cost-effective across the wider health system.

Data is vital in our field, and I think the 2021 GPEx report to which GPSA contributed, “The financial costs and revenue associated with teaching and supervision in general practice”, should be on the Christmas Reading List for all Health Ministers, RACGP and ACRRM Boards.

 

Speaking of Christmas, I do believe in Santa Claus. I wrote him a letter before Christmas, and to my surprise I actually received the requested gift. I asked that, as GP supervision was fundamentally a charitable service, we should be given DGR status and tax exemption from the ATO. To my surprise, in my stocking on Christmas Day was a letter from the ATO confirming that all payments for GP supervision would become tax free and the repayment would be backdated for 20 years and to please find a refund cheque enclosed!! Then I read the fine print… you have never received any payment whatsoever for supervising GP trainees so enjoy your tax-free status on $Zero income!

I would be happy to pay tax on any income from supervision, which I would argue should come through an MBS item number for every phone call and patient review I (and all supervisors) undertake for our registrars.

GPSA is listening and batting strongly on all these issues for training practices and supervisors; I would ask that you all be forthright and vocal about any perceived challenges and instances of neglect in GP training through the year ahead. Your contribution is not only vital to your patients and communities today, but to the health of all Australians going forward.

Wishing you all a very Happy New Year.

Frank Maldari


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Date reviewed: 30 January 2024

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GPSA Chair Report – December 2023

Celebrating the year that was, and excited about what lies ahead!

As I write this Chair report, the last one of this year and my first as Chair, I cannot help but reflect on what a phenomenal year 2023 has been for all of us.

General Practice continues to show we are resilient and resolute despite the challenges that have come our way – attempting to return to a new normal post-COVID, the MBA’s new CPD requirements, and the transition to College-led training to name a few.

The year has also brought opportunities to reconnect, reinvigorate and reinvest ourselves in sharing, teaching and learning across the many events where GPSA has been well represented: PONC, RDAQ, GPME, AAPM, RMA, WONCA, the Australian and New Zealand Prevocational Medical Education Forum, and AIDA. I am sure our members and stakeholders maximised these opportunities to meet with our CEO Carla Taylor, COO Leonie Chamberlain, my predecessor Dr Kevin Arlett, Education Manager Dr Simon Morgan, and Director of Research and Policy Dr Samia Toukhsati.

The GPSA board remains committed to supporting all staff members in our small but effective team in order to deliver high quality educational content, trailblazing research, and useful resources. We envisage these activities and resources will ensure ongoing support to our supervisor and practice manager members, and keep us aligned with our ultimate mission to be the voice of a thriving GP training sector that is united, suitably recognised, rewarded, and respected as the cornerstone of this nation’s healthcare system.

This year we have run a total of twenty (20) webinars that were attended and viewed in record numbers by our members, and the GPSA teaching plans and guides continue to be widely downloaded by supervisors – and at times registrars to support their learning. Kudos to our education team Drs Simon Morgan, Jess Wrigley and Matt Burden, the latter two joining GPSA in an official capacity this year.

The research and policy team has more than its fair share of wins too, having just learnt we’ve successfully secured funding for “Strengthening the recruitment, support, and retention of women GP supervisors: a framework and implementation model” from the Royal Australian College of General Practitioners’ (RACGP) Education Research Grant 2024 program. This is a legacy piece that was conceived under the guidance of Dr Nicole Higgins in her time as Chair.

GPSA also launched the “Scenario” mobile app – a clinical reasoning toolbox designed to augment the learning experience for educators, supervisors, medical students, and trainees alike – and will soon be rolling out a student-facing forum app that ties in with this, “ScenarioEd”, for medical students and trainees across the globe to better experience the international community of practice we work in.

We are indeed still the little team that gets a lot of stuff done!

I take on the role of Chair for the GPSA Board with a mixed bag of emotions. On the one hand, we said goodbye to Dr Kevin Arlett our previous chair, Dr Justin Coleman and Dr Madhu Tamilarasan – all stalwarts in their own right in the GP training domain. You will be missed. Yet at the same time I am looking forward to working with an incredibly talented and diverse Board with two new members, Drs Nick Tellis and Shea Wilcox. We are grateful you have chosen to bring your wisdom and enthusiasm to the GPSA board. This a Board that seeks to represent the best aspects of GP training and its members in its diversity. It captures not just diversity of identity, also of skills, thinking, type of trainees, geographical location, and GP experience/roles. We haven’t quite reached perfection, but I am a firm believer of progress over perfection.

Lastly, I will say this: the coming year will bring us many new issues to navigate such as the 2024 review of the NTCER, new rounds of GP registrar placements, Single Employer Model, and a steady increase in the number of medical student placements in community general practice. Ultimately it is the junior doctor and medical student experience that is a testament to how we have succeeded in enabling and ensuring a safe and thriving learning environment. We will continue to work closely first and foremost with GPRA and indeed other peak bodies – RACGP, ACRRM, AIDA, RDAA and AMA – and advocate for sustainability of our supervisor workforce and training practices.

Training practices and supervisors currently function in an imperfect environment and yet have always delivered effective teaching. Supervisors are to GP education what GPs are to the nation’s healthcare; this expert generalism in training / teaching under our apprenticeship model is not easy to measure and too often feels invisible. Future-proofing GP teaching and training includes making supervision in practice viable and sustainable – financially and in terms of cognitive effort. I hope we do not forget that there is a fine line between heroism and martyrdom.

To the members of GPSA, this is an organisation that is inclusive in values and in action. I invite supervisors irrespective of where you are and who you supervise/teach to join the GPSA Community. The Community reflects our commitment to developing communication channels for peer-to-peer networking and mentoring, and we will receive all member contributions with gratitude.

To end (and this is particularly for the Marvel fans amongst us), I will borrow the words of the one called Optimus Prime: GPSA members and potential members, “it is time to come home!

Date reviewed: 30 November 2023

Please note that while reasonable care is taken to provide accurate information at the time of creation, we frequently update content and links as needed. If you identify any inconsistencies or broken links, please let us know by email.

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GPSA Chair Report – October 2023

Conferences, AGMs, Registrar Placements... It's just that time of the year!

We look forward to welcoming as many members at our AGM as possible, so please attend if you can, and make sure that you keep supporting us just as we support you!

To change it up, this month's Chair Report has been recorded as a short video for you...

For avid readers, I've also provided the written version - something for everyone!

Hi all, another month and we are preparing for the AGM.  There are 3 Elected Director positions vacant, plus the option for 2 appointed Board Director positions available.  Nominations have closed and we are running this AGM as a virtual meeting, so please make sure you can attend, or if not, please get your proxies in to the Company Secretary (Carla) according to the instructions here.
The allocation of Registrars for 2024 has now occurred in most of the country and there has been a lot of angst from Registrars and Supervisors re the process.  ACRRM allocations have been smooth but the very short timeframes and the “open market” approach from RACGP has been fraught.  On the first day the TMS could not cope with the volume of potential applicants, some practices receiving many applicants and others not enough! Positions have been limited with a lot of practices who have received a much smaller number of Registrar positions  than they felt that they were expecting.  There were other issues as well, which were discussed on our Community Platforms. All these comments are being collated and will be discussed with RACGP at our next meeting.  I get the feeling that a lot of the anger and disappointment could have been avoided with much clearer and more timely communication with RACGP members. 
On the brighter side, our new app “Scenario” has been released now and there has been an overwhelming response to it.  This app will allow the user to generate a clinical scenario in a number of different areas with a suggested prompt or two.  These scenarios are great to use in training sessions and everyone who has seen the app so far has been very quick to heap praise upon it.  Get it now from your Apple or Android app store!
We have of course been attending a number of conferences recently, showing our support for Supervisors and Supervising Practices.  We always seem to have someone at the booth talking about quality GP Supervision and looking at the educational supports that we provide as well as looking at “Scenario” and just asking for advice.  We have been presenting various papers at these conferences and this shows the quality of research that GPSA undertakes – congratulations to Sami and our research team at GPSA. 
Please let us know if you want to be involved in the research that is undertaken by us. We are currently developing an evaluation tool for the GPCLE (General Practice Clinical Learning Environment) that is described on our website here

Date reviewed: 26 October 2023

Please note that while reasonable care is taken to provide accurate information at the time of creation, we frequently update content and links as needed. If you identify any inconsistencies or broken links, please let us know by email.

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Date reviewed: 12 October 2023

Please note that while reasonable care is taken to provide accurate information at the time of creation, we frequently update content and links as needed. If you identify any inconsistencies or broken links, please let us know by email.

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GPSA Chair Report – October 2023

Lots of hard work… And it’s beginning to pay off!

As the year races along, it remains a busy time for the GPSA community. With this in mind, I will try to keep my report a bit more succinct this month, however there are a number of important issues I want to draw your attention to:

  1. GPSA members finally recognised for providing the educational continuum from medical student to fellowed GP /RG
  2. Conference Season is upon us
  3. GPSA’s Scenario App to launch for the international healthcare / educational community
  4. The importance of this community of practice for the community at large

I thank you for your support of our recent Media Release outlining our reasons to be enheartened by the long-overdue acknowledgement of our GP supervisor and practice team members in the recently published Medical Deans Australia and New Zealand (MDANZ) Position Paper: Doctors our Communities Need: Building, Sustaining and Supporting the General Practice Workforce in Australia and New Zealand.

Throughout this year we have been actively lobbying the Department and other GP organisations, particularly in the forum of the General Practice Training Advisory Committee (GPTAC), for a concerted effort to unify the many and disparate entities involved in pathways leading to vocational GP training. In the fragmented space we’ve endured for far too long, the placement experiences crucial to attracting more medical students and prevocational doctors to a career in general practice / rural generalism have invariably been under-valued and thus under-supported. Changes arising from the AMC’s new supervision framework also make future supervisor disengagement increasingly likely due to new requirements failing to recognise the experience of AGPT-accredited supervision, resulting in unnecessary and time-consuming duplication of PD activities.

When MDANZ published their Position Paper recommending the need for increased exposure to general practice to improve the attractiveness of our specialty, their focus on more and higher quality GP placements for medical students and prevocational doctors – underpinned by an appropriate level of support and remuneration, and greater consistency across the educational spectrum – effectively signalled the very change Carla and I have been advocating for. DOHAC has been very supportive of our work to facilitate greater interaction between MDANZ, CPMEC and the GP specialty Colleges, recognising the value of turning the spotlight on the GP supervisor as best placed to encourage more interest in our profession. Subsequent discussions with MDANZ indicate a strong willingness to work with GPSA, inviting our members to embed their observations and suggestions in a new curriculum for general practice at the university level. This is really very exciting.

Of course October is ‘Conference Season’ for our sector, and we are excited to be participating in a number of conferences around the country. We hope to catch up with you at any or all of the AAPM, RMA23, WONCA, PMEF and AIDA events. See full details of our conference involvement in the body of the newsletter or on our website here.

We have also been working diligently on the development of our Scenario App, scheduled for release in time for RMA23. This mobile app will produce case scenarios and prompts across a range of topics for supervisors to incorporate into their teaching sessions with registrars and students. It promises to be an indispensable educational tool with international application, noteworthy for its origin right here in Australia. Excitingly, all profits generated by this resource will be directed right back into our support of the GP training sector. Who knows, maybe GPSA will be running its own national networking conference for our members before long?

While GPSA has been directing energy into innovation and greater recognition and reward for our members, we all have a role in fighting for our profession. As supervisors and training practice teams we need to ensure that whatever role we play in supervision is performed at the highest level of quality possible, displaying just why general practice is the best medical specialty and one that all doctors should strive for. The trust and value bestowed upon us by our patients reinforces every day how important we are to the community. Ours is probably one of the most difficult specialties in medicine, but it is also one of the most rewarding – especially when we band together as a community of practice and support one another.

Stay strong and keep on keeping on.

Date reviewed: 25 September 2023

Please note that while reasonable care is taken to provide accurate information at the time of creation, we frequently update content and links as needed. If you identify any inconsistencies or broken links, please let us know by email.

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GPSA Chair Report – September 2023

Never a dull moment…

Is it just me, or has GP / RG training been a hot topic in the medical media through the closing days of this Aussie winter?!

Apart from the IMG rural moratorium, SEM pilots, pay disputes involving hospital doctors in training, the GP crisis hitting hard in the NT, some solid focus on the need to invest in more (and earlier) GP placements for medical students – including this interesting opinion piece from GPSN – and a decent nod to GPSA’s best practice research focus, August 2023 is likely to be remembered for one key topic…


Payroll tax.

It’s a little difficult to perceive the changed interpretation of unchanged state legislation as anything other than general practice being lobbed around as a political football. There are a lot of practices running scared – especially training practices, where payroll tax is already applied to the salaries of GPs in training, putting us in the spotlight as ‘payroll’ calculations will be expected to expand to all the other GPs in our practices including those ‘independent’ practitioners contracting the practice for services, rooms etc.

Some states (Queensland and SA) have offered payroll tax amnesties, and of course there’s been quite a bit of noise about the ACT’s offer of ‘conditional’ amnesty: hingeing on a pledge by practices to bulk bill 65% of their patients. Other jurisdictions have not offered any notion of relief, such as NSW and Victoria, and I’m in two minds about this. I personally am very concerned that the term ‘amnesty’ implies an admission of guilt, much as the concept of ‘exemption’ makes the liability seem beyond challenge. And retrospective application? That has the very real potential of crippling primary healthcare – and in turn our entire health system – across this country.

Benjamin Franklin (that man on the USD $100 note) gave us the saying about death and taxes, and yes, it applies equally now as it did more than 2 centuries ago: one way or another, this seemingly unjust tax will hit us as GPs, and it will change the profession as we now know it. 

I hope and pray that this situation will not deter high quality practices from training the next generation of high quality GPs. This has the potential to even further derail the pipeline of young doctors into this specialty. We already have fewer registrars than training positions and we need to be encouraging entry into general practice, not allowing state governments to sabotage it. 

What is key here is that everyone should really be seeking expert advice as to their next steps in line with their own individual circumstances. And then we should be activating the power of our voice as a community of practice. We know the RACGP and AMA are fronting up to the state governments to tackle this issue, and they have had some real wins along the way. But do you as supervisors and training practice owners / managers feel like your voice is being heard in these discussions?

GPSA members are the last bastions of high quality, independent primary healthcare. We as individuals and businesses are responsible for roughly 85% of the training required for a doctor to achieve fellowship in general practice. We can make or break the medical student / prevocational doctor’s passion for this specialty, which often comes down to how often we denigrate ourselves as “just GPs” and how much of our stress over the sustainability of what we do seeps into our trainee interactions. 

On the flip side, we are substantial in number; but, instead of activating this as a community of practice working together to advocate with one voice, we are either putting our energy into complaining as lots of separate individuals on Facebook / LinkedIn, or burying our heads in the sand… waiting for someone else to do something about it. By rallying together, we can use our undeniable powers of reasoning and deduction to strategise and problem-solve, to plan and find a way forward that doesn’t compromise our values, reputation, or financial stability.

For our part, we continue to work with GPRA, building on the relationship forged through the NTCER review process last year to strengthen the understanding that our memberships represent the two sides of the GP training coin – that we are not just investing our time and energy in short-term workforce but potentially our future colleagues and maybe even business partners. We are shoring up areas of alignment in terms of advocacy, research and education and undertake regular meetings jointly, in particular with state health departments around upcoming Single Employer Model (SEM) pilots, trying to guide and offer assistance as we can. It’s great to report that our offers of help are being well received – and  our views on embedding quality training and ensuring unintended consequences of these individual arrangements don’t do more damage to general practice and the communities that rely on its sustainability are also being heard.

Carla and I also find great value in our regular meetings with both Colleges, where we have the opportunity to advocate strongly for GP supervisors and practice teams and offer our assistance as a sector conduit to keep the changes through this ongoing training transition on track from our members’ point of view. 

We are also meeting with the Commonwealth monthly, which is a terrific platform for this community of practice to have a voice. It is in this forum that we have been able to express that reality that even the goodwill embedded in “My Medicare”, and other Commonwealth strategies being implemented with all the best intentions, are being tainted by the jurisdictional payroll tax ‘attack’. An interesting fact is that if a practice has payroll taxes of significant levels, then these are a tax deduction that reduces what the ATO would otherwise receive from that business. When I suggested that Treasury may be interested in this at one of our recent GPSA / DOHAC meetings, eyebrows were certainly raised!

So you see we have been nurturing a range of relationships across the sector to voice your concerns and solutions. It’s just so important to remember that together we can make a real difference.

Virtually we are bringing our members together through the GPSA Community initiative, and now we are rolling out our face-to-face member networking events starting with Brisbane on Wednesday 20th September. Nothing fancy, just a chance to catch up with your peers and chat with us about the things that matter to you. You can read more about this, and a whole lot of exciting opportunities and updates, in this month’s e-newsletter. And then you can start a conversation with us and with your colleagues via GPSA Community, and help shape the powerful voice this community of practice needs to activate.

Date reviewed: 31 August 2023

Please note that while reasonable care is taken to provide accurate information at the time of creation, we frequently update content and links as needed. If you identify any inconsistencies or broken links, please let us know by email.

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