Teaching Plan: Hyperlipaemia

This teaching plan explores hyperlipaemia, offering comprehensive insights into its diagnosis, management, and impact on patient care. Gain practical skills to apply evidence-based guidelines in clinical practice.

For convenience, you can read through this resource here, or use the pdf tools at the top of the document to download and / or print the file. 

Date reviewed: 14 February 2025

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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Teaching Plan: Breast Lumps

This teaching plan provides essential guidelines for healthcare professionals in managing breast lumps, with a focus on diagnostic techniques and patient care. It offers evidence-based strategies to enhance clinical decision-making and ensure effective outcomes for patients.

For convenience, you can read through this resource here, or use the pdf tools at the top of the document to download and / or print the file.

Date reviewed: 11 February 2025

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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Teaching Plan: Abnormal Uterine Bleeding

This teaching plan provides an evidence-based approach to understanding and managing abnormal uterine bleeding in general practice. It equips GPs with the knowledge and skills to diagnose, investigate, and treat this common but complex condition.

For convenience, you can read through this resource here, or use the pdf tools at the top of the document to download and / or print the file.

Date reviewed: 11 February 2025

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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Finalisation of 2022 NTCER Review

General Practice Supervision Australia (GPSA) and General Practice Registrars Australia (GPRA) are happy to announce the conclusion of the biennial 2022 Review of the National Terms and Conditions for Employment of Registrars (NTCER).

Key NTCER amendments to be implemented across the next 4 training semesters (2023.1-2024.2) include:

  • Staggered 4% increase to minimum Base Rate (full details outlined in table below);
  • Extending Educational Release support for GPT3/CGT3 registrars;
  • Amending Educational Release to provide full-time parity for part-time registrars;
  • Strengthened focus on fatigue management through increase in allocated Administration Time;
  • Revised Preamble to emphasise the minimum nature of the terms and conditions under the NTCER, above which practices and registrars are free to negotiate for mutual benefit and according to commercial viability;
  • Replacing the Restrictive Covenant with a Non-Solicitation clause.

As the peak organisations charged with administering the NTCER, GPSA and GPRA have finalised this review as it began – with collaboration, mutual respect, and a positive outlook. Both organisations recognise there is more to be done and will press ahead with advocacy for increased support and investment in the future of primary health care.

The main win for both organisations is the relationship forged through the underpinning principles GPRA and GPSA set for this review process in July 2022:

1)           Models of employment for GP registrars across Australia need to be fair and equitable, delivering working conditions and remuneration that compares with other specialist trainees while taking into account the context of training practices;

2)           General practice is a rewarding medical specialty and an attractive vocational pathway for junior and/or pre-vocational doctors;

3)           GP trainees and GP supervisors are equally desirous of and entitled to a quality training experience;

4)           GPRA and GPSA, as the recognised national peak bodies representing all GP registrars, GP supervisors and GP training practices, have a critical role in advising all levels of government on all matters of relevance to the GP training sector;

5)           Appropriate support and funding for GP supervisors and GP training practices is crucial for the sustainability of the nation’s primary health system, which in turn underpins the nation’s wider healthcare system.

As part of this process, future collaborations between GPSA and GPRA on a variety of projects have been agreed, including the co-development of:

  • A Fatigue Management Policy;
  • Employment contract templates;
  • Resources to assist practice managers overseeing the employment of GP or RG registrars;
  • FAQs for registrars and practices;
  • A shared benchmarking process to inform future biennial NTCER reviews.

Recognising the need to minimise the impact on training practices in the current climate, agreement has been reached to stage base rate and administration changes across the next 4 training semesters, leading into the next review period in Semester 2 of 2024. A summary of these changes and their timing is included below:

Implementation of Changes to NTCER by Training Semester

Educational release (clause 9.2)

Where GPT3s have mandated workshop requirements during standardly rostered hours, these will be included as paid time by practice (unless on a weekend or after
hours)

 

Restrictive covenant (clause 17)

Clause to be removed from NTCER and replaced with non-solicitation of patient and
staff

 

Parity for part-time registrars re
educational release
(clause 9.2)

Training practices to provide part-time GP trainees educational release in parity with full-time GP trainees

 

Redrafted “Preamble” and “About the
Agreement”

Updated to reflect staging of changes and new framework for biennial
review

 

3% increase to minimum base rate (per current Remuneration Schedule) on top of indexation

 

Administration time (clause 9.3)

Increase to scheduled 30 mins per session (half day) to max 5 hours per week

1% increase to minimum base rate on top of indexation

Next biennial review To be carried out under mutually agreed process and timeframe in 2024.2, with view to conclusion before recruitment for training placements commences (i.e. by September 2024 for 2025.1)  

The updated NTCER Agreement is available for viewing and downloading here.

Date reviewed: 15 January 2025

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 is GPSA concerned about the new payroll tax ruling in QLD?

Your say in whether the new QLD SRO ruling poses a threat for GP training

GPSA represents GP supervisors and training practices, without whom the future for the general practice specialty would be very bleak.

By extension, any threat to the profession that poses a threat to GPs who supervise, and the training practices that offer employment to registrars through their training, is of major concern to GPSA.

If this payroll tax threat results in a mass departure of GPs from the specialty, inevitably there will be a great many experienced GP/RG supervisors amongst them.

If registrars find themselves impacted by a shrinking pool of supervisors, extra pressure on practice workforce with departing GPs, and/or heightened tensions in the training practice as new structures and systems are rushed into place to mitigate the likely effect of the payroll tax ruling, this will undermine the sustainability of GP training and in turn the profession. So this is what is making GPSA concerned.  

Through this rapidly-implemented, quick member survey, our goal was to give your individual voices the volume of this community of practice, loudly adding the unique and very important perspective to the College and AMA discussions with state and federal governments on this issue.   

When the announcement came through that there’d be no retrospective application under a so-called ‘amnesty’, it could be argued that three minutes of your time made a mighty big difference.

Read here how your voice on this issue was interpreted in the ongoing media coverage.

Summary of Rapid Survey - January 2023

Date reviewed: 24 August 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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Are we there yet?!

The transition of GP training from the RTOs to a College-led model has dominated sector conversations for what seems a very long time; however, with February just around the corner, time is fast running out to ensure we are all set for the new era of training.

Is this all we should be worried about?

It’s easy to be distracted by the negativity surrounding us, but I’m yet to meet a GP who took on the supervision of a registrar because it was “easy”. As supervisors, our role is to transfer our passion for quality and continuity of patient-centred care onto the next generation of GPs, regardless of political or economic pressures, major changes in the GP training model or even a little thing like a pandemic! This means we need to be focusing on solutions rather than being dragged down by the many challenges and threats the profession is currently facing. To this end, the power of one is real. You as an individual have a voice through GPSA: a voice given volume by this community of practice we are working to support through innovative networking opportunities underpinned by new and improved systems.

Right now, we are ensuring your voice is present in discussions about the transition, and in our review of the NTCER with GPRA. We are speaking on your behalf at sector stakeholder fora like the meetings of the General Practice Training Advisory Council (GPTAC) and the National Council of Primary Care Doctors (NCPCD), and frequent meetings with ACRRM, RACGP and the Department. We have also started working with the Workforce Planning and Prioritisation (WPP) organisations to contextualise their reports on training needs and capacity with your localised narratives; and we speak regularly with the CEOs of the RTOs to ensure nothing slips through the cracks in the transition, noting that GPSA has been offered the regionally-based training modules and other resources developed by these organisations so we can provide our members with ongoing free and open access to these valuable materials.

A big concern for us has been how GPSA can best support supervisors and practices to make the transition as seamless as possible and keep the sector focused on sustainability of the profession to guarantee continuity and stability in GP training. Taking our role of conduit quite literally, we have devoted a lot of our resources to providing you with regular transition updates via webinars, e-newsletters, social media and links on our website; we have also been madly reviewing new College policies, guidelines and handbooks specific to the supervision of vocational GP trainees, determined to minimise the burden on our members – and maximise the attractiveness of GP training – under the new regime.

We recognise our work in this space has only just begun, and will continue devoting significant time and energy throughout the next triennium to hold the Colleges to account as the new custodians of GP training in this country. But what we need in order to maximise our efforts going forward is your contribution, your questions and feedback and requests for our input. In 2023, we will be introducing a forum-based website to create easily accessed channels of communication for our members to connect with us, with the Colleges and DOHAC, but most importantly with each other. GPSA has a voluntary Board of Directors and a very small number of paid staff; we are a not-for-profit organisation that exists for the benefit of its members, so we really do need the connection with you we are planning for this new platform and implore you to be active in the community this will help to enhance.

In the meantime, we are still trying to get a solid handle on a few of the new concepts to better prepare you for 2023, like RACGP’s Work-Based Assessments (WBAs). At this stage we can confirm that the WBA program will be implemented progressively across 2023 and 2024. There will be a soft rollout of the program with the first assessment not due until the middle of the first GP term. The assessments are very similar to those currently being completed by supervisors in existing programs. The RACGP teams in each region will provide education and support for supervisors about the WBA program.

While we had a Q&A-style webinar on the National Consistent Payment (NCP) framework with DOHAC’s Martin Rocks in mid-November, we are only now being presented with how each College will apply the Flexible Funding that will top up the NCP payments. ACRRM will deliver a webinar with us on their Flexible Funding model on 15th December to explain their priorities and how supervisors, practices and registrars will be able to access these funds.

Still on the subject of webinars, if you’re one of the many struggling to register for practice / supervisor payments under the NCP (even after the two webinars GPSA ran in November, plus the FAQs we developed, to tackle the confusion), Services Australia has accepted our request to do a live walk-through of the PRODA and HPOS processes for our members, which we will of course record and make available for those who can’t attend. Carla is just awaiting confirmation of the date, but will make certain this happens this side of Christmas (and will let you know once this date is locked in).

So it’s not all doom and gloom in general practice, as we found in October at the ACRRM/RDAA RMA22 conference. For the 1500+ RACGP members in Melbourne for the last weekend in November, three years without large-scale face-to-face events made GP22 extra special too.

Current GPSA Chair Dr Kevin Arlett with former GPSA Chair (current RACGP President) Dr Nicole Higgins and former Board member Dr Alan Leeb at GPSA’s GP22 booth

Despite the temptation to wander further into the Melbourne Convention and Exhibition Centre to check out the other conferences (one in particular), the turn-out was great and the energy high as we took the opportunity to chat within the same postcode and without the computer screens!

Amongst the many topics of interest at GP22, personally I’d rank CPD right up there. From 2023, the Medical Board of Australia (MBA) is changing CPD for all doctors, in all disciplines, across Australia. Moving from a points-based to a time-based model, three new CPD activity types will need to be covered in 50 hours per annum:

  • Educational activities (EA) that expand your knowledge and skills
  • Reviewing performance (RP) activities that encourage you to reflect on feedback about your work
  • Measuring outcomes (MO) activities that use your work data to ensure quality results

In response to these changes and our advocacy around reducing burdens for GP supervisors, the College is looking at opportunities for primary supervisors to have our supervision work recognised as significantly fulfilling the new MBA requirements in terms of CPD hours. We are also working with both Colleges to have participation in GPSA research and attendance of our webinars / workshops automatically applied as CPD, which will be helpful for secondary supervisors and anyone not supervising a registrar in 2023 too.

I can’t mention GP22 without acknowledging the GPSA team there with me – Carla Taylor (CEO), Leonie Chamberlain (COO), Jane McMahon (Admin), Karen Andrews (Governance), Lachlan Butcher (Member Services), Dr Samia Toukhsati (Research), Dr Simon Morgan (Education), Dr Justin Coleman (my fellow Board member) and Dr Nicole Higgins (my predecessor!). If watching Nicole step into the role of President at the RACGP AGM was an honour, I’ve yet to find the words to describe how it felt to listen to Simon and Justin hammering out the crowd favourites as members of the all-doc band at the conference dinner!

As December kicks in, I wish you all a very Merry Christmas, and a rewarding, enjoyable, stress-free New Year.

Date reviewed: 15 April 2025

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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Burnout? It's more common than not

At the GP22 conference in Melbourne at the end of November 2022, GPSA’s Director of Research, Dr Samia Toukhsati, presented the findings she developed with Monash University’s Dr Rebecca Kippen and GPSA’s former and current CEOs, Glen Wallace and Carla Taylor.

The aim of GPSA’s study was to explore the wellbeing and selfcare of GP supervisors in Australia.

The method included use of the 16-item Oldenburg Burnout Inventory to evaluate disengagement and exhaustion through a procedure involving:

Monash Human Research Ethics Committee approval (#19442) Feb 2022
Completion of the GPSA National Supervisor Survey by GPSA members in March-April 2022
Analysis of survey data, in particular socio-demographics, GP supervision experience, access to leave, indications of burnout and selfcare

 

What the literature says about burnout...

Burnout is an ‘occupational phenomenon’(1)

  • Unrelenting workplace demands
  • Unmeetable goals

Burnout is common in GPs around the world(2, 3), including GP registrars(4)

  • Stressful, high pressured environments
  • High workload and long hours
  • Emotional strain(5)

Burnout occurs when one’s ‘wellbeing reservoir’ is depleted(4)

 

 

Discussion points

Burnout impacts over 70% of GP supervisors

Modifiable personal risk factors include:

  • Working when unwell
  • Selfcare (need to increase daily balance / self-awareness and mindfulness)

Benefit of increasing personal agency to set boundaries: empowerment and choice

Burnout represents a systemic workplace and workforce problem

Create resilient workplaces, not just resilient workers(6)

  • Supportive culture
  • Supportive policy
  • Supportive tools

REFORM!

Change needed at the sector level, requiring a systems and government response(7)

  • Urgent and increased government investment in general practice and workforce training
  • National guidelines and organisational policies to prevent healthcare worker burnout(7)
  • Model Work Health and Safety Regulations (as at 14 Apr 2022)(8) – 55A Psychosocial hazards; 55B Psychosocial risks; 55C-D Control measures

References

  1.  World Health Organisation. International Classification of Disease for Mortality and Morbidity Statistics (ICD), 11th revision, Geneva, 2018
  2. HIMMS and NUANCE Communications. From overload to burnout. What clinicians think. 2021. Available at www.nuance.com/content/dam/nuance/en_uk/collateral/healthcare/white-paper/wp-from-overload-to-burnoutwhat-clinicians-think.pdf
  3. Shen et al. (2022). The global prevalence of burnout among general practitioners: a systematic review and meta-analysis. Family Practice, 2022, XX, 1–8. https://doi.org/10.1093/fampra/cmab180
  4. Prentice et al. Burnout, wellbeing and how they relate: A qualitative study in general practice trainees. Med Educ. 2022; 1-13.
  5.  Zarei et al. Prevalence of Burnout among Primary Health Care Staff and Its Predictors: A Study in Iran. Int. J. Environ. Res. Public Health 2019, 16, 2249; doi:10.3390/ijerph16122249
  6. Henderson JD. Self-Care is Not the Solution for Burnout. Medium, 14th Jan 2022. Available at https://index.medium.com/self-care-is-not-the-solution-for-burnout-6969bc0a2de6
  7. Warby T. Why Australia needs a systemic response to burnout. newsGP 24 Aug 2022. Available at https://www1.racgp.org.au/newsgp/gp-opinion/why-australia-needs-a-systemic-response-to-burnout
  8. Work Health and Safety Regulations 2011. Available at https://www.safeworkaustralia.gov.au/sites/default/files/2022-06/model_whs_regulations_-_14_april_2022.pdf

THIS IS JUST ONE EXAMPLE OF THE RESEARCH GPSA UNDERTAKES IN OUR EFFORT TO DEVELOP BEST PRACTICE RESOURCES, CREATE POLICIES FOR THE IMPROVEMENT OF GP TRAINING CONDITIONS, AND ADVOCATE ON BEHALF OF OUR MEMBERS.

TO REPRESENT YOU FAITHFULLY, WE NEED TO HEAR YOUR VOICE. PLEASE CONSIDER PARTICIPATING IN OUR MEMBER SURVEYS AND RESEARCH INTERVIEWS, AND REACH OUT TO US WITH ANY ISSUES / CONCERNS / QUERIES AT SUPPORT@GPSA.ORG.AU.

Date reviewed: 24 August 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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Best Practice in RTO-Led GP Training…

What do we need to take with us into the Future?

The RACGP Education Research team invites you to join a focus group discussion about RTO-led best practices in general practice training to ensure they’re not lost in the transition.

You’ll be compensated for your time with $150 via PayGP.

Discussions will explore practices and programs you’ve found effective in supporting training and preparing trainees for independent practice.

Research aims and objectives

We’re hoping to capture what’s working well, what could be strengthened and what’s possible moving forward.

The project will inform the future directions of GP training in relation to trainee recruitment and retention, and the trainee-supervisor/employer relationship.

What you need to do

First, read the participant information and consent form. If you’re interested in participating, register your interest. You’ll then be asked to indicate your availability.

If you have a strong preference against participating in a focus group discussion, individual interviews can be arranged.

Feel free to extend this invitation to colleagues who may be interested in participating.

Ethics approval

The project has been approved by the RACGP National Research and Evaluation Ethics

Committee (Project number 22-133). The Zoom meetings will be recorded.

These discussions are being conducted as one component of a 2022 RACGP-led Education Research Grant project.

Questions?

Email Drs Nancy Sturman and Sophie Vasiliadis at rsc.erg@racgp.org.au

Date reviewed: 04 November 2022

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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National Consistent Payments:
Training Practice Support under the AGPT program 

Since the first semester of 2023, training support payments relating to the Commonwealth-funded AGPT program have been administered through Services Australia as part of the National Consistent Payments (NCP) framework. These payments are available to accredited training practices, supervisors and registrars.

For more information on the program please see: National Consistent Payments Framework | Australian Government Department of Health and Aged Care.

The 4 types of payments under the AGPT program

Paid directly to the accredited training practice – the practice must register in the Organisation Register and add their bank account details to get these payments.

Authorised through the RACGP/ACRRM systems, these are paid directly to the accredited training practice, unless Services Australia is advised to pay the supervisor directly

Paid directly to the registrar, not the practice, these payments help with some of the costs of relocating to a new practice, education, training, and other registrar expenses

Paid to accredited training practices who can host a salary support person for Aboriginal and Torres Strait Islander health training.
The practice must register in the Organisation Register and add their bank account details – Services Australia will pay any of the practice, supervisor, or registrar.

How NCP payments work

The Department of Health and Aged Care (DOHAC) delivers the AGPT program through a contract with RACGP and ACRRM (the Colleges). DOHAC decides who is eligible for AGPT training support payments and how much they should be paid at any point in time.

The Colleges calculate payments for everyone registered in the AGPT Program, transmitting this information to Services Australia as individual payment requests to be filled directly through the PRODA/HPOS systems.

How to access NCP payments through Services Australia

The first step is for the practice associate or an authorised contact to register their participating providers in the Organisation Register.

NOTE:
Services Australia’s payment system identifies the Australian General Practice Training (AGPT) program as “the General Practice Training Program (GPTP)”. All participating practices, supervisors and registrars should note the AGPT program is the same as the GPTP on the Services Australia’s payment system.

Date reviewed: 24 August 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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Who are the first responders for GP registrar wellbeing?

Those involved in GP training often wear many different hats: among these is the nebulous role of pastoral carer to support the wellbeing of GP registrars.

By sharing your experiences as providers and recipients of wellbeing support, we can identify strategies for improving guidance regarding the scope and responsibilities associated with this role.

This study involves a 10-15 minute online questionnaire, and, if you are interested, two optional follow-up surveys at 6-month intervals. Participants are invited to enter a draw for a $500 gift voucher.

If you are interested in participating, please read the Explanatory Statement and then go to the online questionnaire.

This study has been approved by the Monash University Human Research Ethics Committee (project number 35523).

Date reviewed: 16 April 2025

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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