Supervision Resources

GPSA has developed an extensive library of resources to support you in best practice supervision. 


These are curated below under the following headings:
  • * Resources by type
  • * Resources by topic
  • * Consultation Skills Toolbox
  • * The IMG Supervisor’s Toolbox
As there can be some overlap between supports / resources for the supervisor and the practice, we encourage you to explore links both on this page and those under Employment Support.

First Nations Health

Consultation Skills

Clinical Conditions

Clinical Presentations

Patient Groups


First Nations Health

Best Practice Aboriginal and Torres Strait Islander Health – Part 1Webinar and Podcast
Best practice Aboriginal and Torres Strait Islander health – part 2Webinar
Telehealth and Aboriginal and Torres Strait Islander patientsWebinar and FAQ
Telehealth with Aboriginal patients who are hard of hearingFAQ

Consultation Skills

Assessing your registrar’s Telehealth consultationsWebinar and FAQ
Managing UncertaintyWebinar, FAQ and Podcast
Patient BoundariesWebinar, FAQ and Podcast
Teaching Consultation SkillsWebinar, FAQ and Podcast
Teaching Professional and Ethical PracticeWebinar, FAQ and Podcast

Clinical Presentations

Addiction medicineWebinar
Advanced care planningWebinar, FAQ and Podcast
Behavioural issues in childrenWebinar, FAQ and Podcast
Chronic painWebinar and Podcast
Common infections part 1Webinar, FAQand Podcast
Common infections part 2Webinar, FAQ and Podcast
ContraceptionWebinar, FAQ and Podcast
Depression in Young PeopleWebinar and FAQ
DermatologyWebinar, FAQ and Podcast
DementiaWebinar 1, and 2,FAQ and Podcast Part 1 and Part 2
Disability careWebinar, FAQ and Podcast
EndometriosisWebinar and FAQ
HIVWebinar, FAQ and Podcast
LGBTQIA+ inclusive healthcareWebinar, FAQ and Podcast
Long COVIDWebinar, FAQ and Podcast
Managing patients with a history of childhood traumaWebinar, FAQ and Podcast
Managing the patient with ADHD – helping your registrar deliver best practice careWebinar, FAQ and Podcast
Men’s healthWebinar, FAQ and Podcast
Mental health top tipsWebinar and FAQ
Overweight and obesityWebinar, FAQ and Podcast
Prenatal screeningWebinar, FAQ and Podcast
RACF careWebinar, FAQ and Podcast
STIsWebinar and FAQ
Veteran’s healthWebinar, FAQ and Podcast
Workers compensationWebinar and Podcast


Ad hoc supervision and informal teachingWebinar, FAQ and Podcast
Are they safe in there – clinical supervision and RCAWebinar, FAQ and Podcast
Best practice supervision – a refresherWebinar and Podcast
Helping registrars shine – performance issuesWebinar, FAQ and Podcast
Improve safety with a ‘call for help’ listWebinar, FAQ and Podcast
Introduction to GP supervision – roles, responsibilities and rewardsWebinar and FAQ
Supervising the IMG registrarWebinar, FAQ and Podcast

Teaching, Learning, Assessment & Feedback

Clinical reasoningWebinar, FAQ and Podcast
Consultation analysis and feedbackWebinar, FAQ and Podcast
Formal teaching and problem case discussionWebinar and FAQ
Learning planningWebinar and FAQ
Observing your registrar – refining your skillsWebinar, FAQ and Podcast
Study skillsWebinar and Podcast
Teaching and learning in general practiceWebinar and Podcast

Learning Environment

The Learning EnvironmentFAQ
Vertical and horizontal learning integration in general practiceGuide

Patient Safety

Are they safe in there – clinical supervision and RCA Webinar
‘Call for help’ listWebinar
Patient boundariesWebinar
Supervision planTool
Supervision in After-Hours Environments in General PracticeGuide and Tool
Patient Safety IncidentsTeaching Plan

Supervisor Role

Best Practice Supervision in general practice – a refresherWebinar
Introduction to GP supervision – roles, responsibilities and rewardsWebinar and FAQ
Teaching Clinical Reasoning in general practiceGuide
The New Supervisor Guide to Best Practice Supervision in general practiceGuide and FAQ

Consultation Skills

Clinical Reasoning in general practice Guide, Webinar, FAQ, Podcast and How To… resource
Consultation skills teachingWebinar and FAQ
Consultation analysis and feedback Webinar and FAQ
Follow Up and Safety Netting Teaching Plan
Health Education, Brief Intervention and Motivational InterviewingTeaching Plan
History TakingTeaching Plan
Managing Uncertainty in General PracticeGuide, Webinar, FAQ and Teaching Plan
Patient-Centred Care Teaching Plan
Physical ExaminationTeaching Plan
Polypharmacy & DeprescribingTeaching Plan
Preventative Health and ScreeningTeaching Plan
Quality Medical RecordsTeaching Plan
Prescribing Mechanics Teaching Plan
Rational Prescribing in general practiceGuide and Teaching Plan
Rational Test OrderingTeaching Plan
Telehealth consultationsWebinar and FAQ
Time ManagementTeaching Plan
Writing Quality ReferralsTeaching Plan

Teaching & Learning

Helping your registrar plan their learningGuide, Webinar, FAQ and 4R Learning Needs Assessment Tool
Teaching and learning in general practice planningWebinar, FAQ and Podcast
Practice-Based Teaching in General PracticeGuide
Formal teaching and problem case discussionWebinar, FAQ, Podcast and How To… resource
Ad hoc supervision and informal teachingWebinar, FAQ and Podcast
Observing your registrar – refining your skills webinar and FAQWebinar, FAQ and Podcast
Teaching Professionalism in General PracticeGuide
Teaching professional and ethical practice Webinar, FAQ, Podcast and Teaching Plan
Random Case Analysis in General PracticeGuide and How To… resource

Assessment & Feedback

Helping registrars shine – performance issues Webinar, FAQ and Podcast
Giving Effective Feedback in general practiceGuide and How To… resource
Identifying and Supporting GP Registrars at RiskGuide

Pastoral Care

Doctors’ Health and Self-CareTeaching Plan
Identifying and Supporting GP Registrars at RiskGuide
Identifying and Supporting GP Supervisors in DifficultyGuide and FAQ

First Nations Health

Aboriginal and Torres Strait Islander health assessmentsTeaching Plan
Aboriginal and Torres Strait Islander health in general practiceGuide
Identifying Aboriginal and Torres Strait Islander statusTeaching Plan
Aboriginal and Torres Strait Islander telehealth consultations Webinar and FAQ
Best practice Aboriginal and Torres Strait Islander health part 1Webinar and Podcast
Best practice Aboriginal and Torres Strait Islander health part 2Webinar
Introduction to Aboriginal and Torres Strait Islander people and their healthTeaching Plan
Teaching yourself and your registrar about Aboriginal and Torres Strait Islander healthPodcast


LGBTQIA+ Health and Inclusive Healthcare in General Practice An Introduction to Teaching and LearningGuide, Webinar, FAQ and Podcast

Supervising IMGs

Supervising the International Medical Graduate (IMG) GP RegistrarGuide, Webinar, FAQ and Podcast
IMG Registrar Self-AssessmentTool
IMG Registrar Supervisor AssessmentTool

Exam Support

Assessment successWebinar
Preparing GP Registrars for the Key Feature Problem (KFP) examFAQ
RACGP Clinical Competency Exams (CCEs)Webinar and FAQ
Registrar ExaminationsFAQ
StAMPS Assessment PreparationFAQ
Study Skills for GP Registrars: Studying Smarter, Not HarderGuide and Webinar
Supporting GP Registrars who have failed an ExamWebinar and FAQ
Supporting RACGP registrars with Preparation for the AKT and KFPWebinar and FAQ

Clinical Presentations

Abdominal PainTeaching Plan
Abnormal Liver Function TestsTeaching Plan
Abnormal Uterine BleedingTeaching Plan
Acute BronchitisTeaching Plan
Acute MonoarthritisTeaching Plan
Addiction MedicineWebinar
Adolescent HealthTeaching Plan
Advanced Care PlanningWebinar, FAQ and Podcast
Allergic RhinitisTeaching Plan
Antenatal CareTeaching Plan
Antibiotic PrescribingTeaching Plan
AnxietyTeaching Plan
AsthmaTeaching Plan
Atrial FibrillationTeaching Plan
Attention Deficit Hyperactivity Disorder (ADHD)Webinar, FAQ, Podcast and Teaching Plan
Back painTeaching Plan
Behavioural Issues in ChildrenWebinar, FAQ and Podcast
Breast LumpsTeaching Plan
CellulitisTeaching Plan
Chest PainTeaching Plan
Child AbuseTeaching Plan
Childhood TraumaWebinar and FAQ
Chronic Kidney DiseaseTeaching Plan
Chronic PainWebinar and Podcast
Coeliac DiseaseTeaching Plan
Common Infections part 1Webinar, FAQ and Podcast
Common Infections part 2Webinar, FAQ and Podcast
ContraceptionWebinar, FAQ and Podcast
CoughTeaching Plan
Depression in Young PeopleWebinar and FAQ
DermatitisTeaching Plan
DermatologyWebinar, FAQ and Podcast
Diagnostic ErrorsTeaching Plan
DiarrhoeaTeaching Plan
Disability careWebinar, FAQ, Podcast and Teaching Plan
EndometriosisWebinar and FAQ
Genomics in general practiceTeaching Plan
Hand and WristTeaching Plan
HeadacheTeaching Plan
HIV Webinar and FAQ
HypertensionTeaching Plan
ImmunisationTeaching Plan
Inflammatory Bowel DiseaseTeaching Plan
InsomniaTeaching Plan
Intimate Partner ViolenceTeaching Plan
Irritable Bowel SyndromeTeaching Plan
Knee PainTeaching Plan
Leg UlcersTeaching Plan
Long COVIDWebinar, FAQ and Podcast
LUTS For MenTeaching Plan
LymphadenopathyTeaching Plan
MedicareTeaching Plan
Men’s HealthWebinar and FAQ
Menopause Plan
Mental HealthWebinar, FAQ and Podcast
Multiple MyelomaTeaching Plan
Neck PainTeaching Plan
Nocturnal EnuresisTeaching Plan
Non-Melanoma Skin CancerTeaching Plan
OsteoarthritisTeaching Plan
OsteoporosisTeaching Plan
Otitis MediaTeaching Plan
Overweight and ObesityWebinar, FAQ, Podcast and Teaching Plan
Peripheral NeuropathyTeaching Plan
Peripheral OedemaTeaching Plan
Peripheral Vascular DiseaseTeaching Plan
Pigmented Skin LesionsTeaching Plan
PolyarthritisTeaching Plan
Polymyalgia RheumaticaTeaching Plan
Prenatal ScreeningWebinar, FAQ and Podcast
RACF CareWebinar, FAQ, Podcast and Teaching Plan
Red EyeTeaching Plan
SepsisTeaching Plan
Shoulder PainTeaching Plan
SinusitisTeaching Plan
Smoking CessationTeaching Plan
Sore Throat Teaching Plan
STIsWebinar, FAQ, Podcast and Teaching Plan
Superficial BursitisTeaching Plan
Thyroid DiseaseTeaching Plan
TIA & StrokeTeaching Plan
TinnitusTeaching Plan
Upper Respiratory Tract InfectionTeaching Plan
Urinary IncontinenceTeaching Plan
Urinary Tract InfectionTeaching Plan
Veteran’s HealthWebinar, FAQ and Podcast
Viral IllnessTeaching Plan
Vitamin B12 DeficiencyTeaching Plan
Workers CompensationWebinar, Podcast and Teaching Plan


There have been a number of formal models of the consultation described in the international literature. Consultation models can be used as a framework to teach registrars about the importance of a structured, patient-centred and safe consultation.
In this video, Dr Simon Hay gives an overview of some of the key models for the GP consultation and some practical advice on assessing the registrar undertaking a consultation.
Further reading:

Neighbour’s ‘The Inner Consultation’ model

Neighbours Model
Neighbour’s model proposed that the general practice consultation is ‘a journey, not a destination’, and described five ‘checkpoints’ along the way.


  • Connecting: Have we got rapport?
  • Summarising: Do I know why the patient that has come today?
  • Handing over: – Have we agreed on a management plan?
  • Safety netting: – Have I covered the ‘what ifs’?
  • Housekeeping: – Am I in good shape for the next patient?
  • Neighbour R. The Inner Consultation: how to develop an effective and intuitive consulting style. 2nd ed. Oxford: Radcliffe Medical Press; 2004

Calvary Cambridge model

The Calgary Cambridge Model incorporates the physical, psychological and social aspects of the consultation. In addition to its five stages, there are two ‘threads’ that run throughout the consultation.


Ron Roth model

Ron Roth, a GP supervisor from Victoria, has developed his own model as discussed in this recent journal article published in the AJGP (2022):
A new framework for teaching the art of general practice consultation to registrars and supervised doctors.

He presents his model in this GPSA webinar.

Structuring the consultation

Registrars often struggle to facilitate an effective, organised, and time-efficient consultation with their patients.

Connecting and building the doctor-patient relationship

A critical first step in the consultation is to connect with the patient and establish a relationship. This includes building rapport and limiting use of the computer.

Communicating effectively

Effective communication is an essential skill in general practice consultations. There is strong evidence linking good communication with improved outcomes for both patients and doctors.
The ‘art of communication’ has been described as applying the most appropriate skills to suit each unique patient-doctor interaction.
In this video, Simon Morgan and Jess Wrigley discuss how to teach consultation skills using the Kalamazoo Consensus Statement
Further reading:

Gathering data

Gathering data comprises the skills of effective history taking and physical examination.

Managing uncertainty

Undifferentiated presentations are very common in general practice and establishing a pathological diagnosis is often not a realistic goal. Management of uncertainty of both diagnosis and management is an essential skill for general practitioners.
In this video, Simon Morgan and Justin Coleman discuss some practical strategies to support registrars to better manage anxiety.
Further reading:

Providing patient-centred care

Patient-centred care can be regarded as where ‘the provider tries to enter the patient’s world to see illness through the patient’s eyes’. Common elements of patient-centred care include informing and involving patients; eliciting and respecting patient preferences; engaging patients and sharing decisions in management planning; and continuity of care.

Providing culturally safe care

Cultural competence is defined as ‘the development of awareness and respect for differences in social structure and culture, and acknowledgement of the impacts of these on health and wellness beliefs and ability to engage with health services’. Cultural competence is a core aspect of safe general practice.
In this video, Karen Nicholls discusses an approach to providing culturally safe care to Aboriginal and Torres Strait Islander patients.
Further reading:

Clinical reasoning

Clinical reasoning has been defined as ‘the sum of thinking and decision-making processes associated with practice … it enables practitioners to take … the best judged action in a specific context.’ It is a core element of high-quality general practice. Clinical reasoning encompasses skills in effective data gathering (history, examination and investigation); data synthesis and interpretation; communication; managing uncertainty; patient-centred care, and evidence-based medicine. 
In this video, Simon Morgan explores clinical reasoning in the general practice training setting.
Further reading / resources:

Being professional and ethical

Medical professionalism is regarded as one of the core factors in providing high-quality patient care. Professionalism is closely associated with improvements in doctor-patient relationships, patient satisfaction, and healthcare outcomes.
In this video, Justin Coleman and Simon Morgan discuss teaching and learning professional and ethical practice in general practice.
Further reading:

Providing preventive health care

Preventive healthcare is a core aspect of many consultations. It includes the prevention of illness, screening activities for the early detection of specific disease, and the promotion and maintenance of health. Preventive health is particularly important in addressing the health disparities faced by disadvantaged population groups, like Aboriginal and Torres Strait Islander people.

Motivational interviewing

Effective health education involves the provision of accurate, timely, evidence-based, quality health information to patients, taking into account sociocultural factors and their level of health literacy. Two core skills for effective delivery of health education are brief intervention and motivational interviewing. 


Rational test ordering

Non-rational testing, and/or over-testing, is increasingly recognised as an important issue in health care. Rational use of investigations is one of the core skills of Australian general practice training and previous research has demonstrated that this is a challenging area for GP registrars.

Rational prescribing

Rational prescribing is ‘the judicious, appropriate, safe and efficacious use of medicines’, and is known to be a challenging area for GP registrars.

Management planning

Management planning is a core aspect of the effective and safe consultation.

Follow-up and safety netting

The basis of effective continuity of care in general practice is appropriate patient follow up. Safety netting is a key element of follow-up to ensure patient safety and help manage uncertainty.
Closing the consultation: Language examples
GPSA teaching plan: Follow Up and Safety Netting
2009 BJGP. Diagnostic safety-netting


The basis of effective continuity of care in general practice is appropriate patient follow up. Safety netting is a key element of follow-up to ensure patient safety and help manage uncertainty.
Closing the consultation: Language examples
GPSA teaching plan: Follow Up and Safety Netting
2009 BJGP. Diagnostic safety-netting

Recognising limitations

Recognising one’s limitations and appropriate help-seeking is a core general practice skill, and a fundamental aspect of safe practice and effective learning.
In this video, Gerard Ingham discusses the call for help list.
Further reading:

Managing time

Time management in the general practice environment is particularly challenging, where every clinical assessment is required to be sufficiently comprehensive in scope to manage the presenting issues and exclude potentially serious causes, but also time efficient in order to meet patient demand. Time management is a core consulting skill but one that can take some time to develop.

Breaking bad news

Adolescent health

Alcohol and other drugs

Mental health

Sexual health

Saying no

Angry patient

Intimate partner violence

‘Heartsink’ patients


Telehealth, using either phone or video technology, has increased significantly over recent years as a result of the COVID-19 pandemic. Telehealth consultations can be particularly challenging for IMG doctors as they require high level oral language skills to compensate for unavailability of non-verbal clues.
In this video, Simon Morgan discusses how to assess the registrar undertaking a telehealth consultation.
Further reading:

General teaching tips and resources

Avoid generalisations and stereotyping

International Medical Graduates are not a homogenous group, and have a wide range of knowledge, skills, attitudes, experience, and backgrounds, even within the same cultural group. This may sound obvious, but it is critical to avoid generalisations or stereotyping, and for supervisors to regard every IMG as unique. Where issues arise, it is critical to specifically ‘diagnose’ the problem (educational, personal etc.), rather than generalising it as being ‘cultural’ or ‘language’.

Identify differences, not deficits

While often associated with posing educational and training challenges, IMG GPRs can bring a wealth of positive skills, attributes and expertise to GP training and the general practices in which they train. Such positives include:
  • A broader world view

  • Experience of alternative health systems (often in disadvantaged communities)

  • Specific clinical skills

  • Second (or third) languages

  • Resilience to setbacks

Reflecting this, a recent paper on supporting IMG GPRs argued that the focus on supervision of IMG GPRs should be on ‘difference’, not ‘deficit’. Furthermore, the authors stated that labelling IMGs as having learning needs was unfair without also acknowledging their unique strengths.

Expect the need for broad supports

The IMG GPR is may need increased support across all facets of training – educational, pastoral, personal and professional.
While the transition from the hospital to the general practice setting is potentially highly challenging for all registrars – characterised by a breath of clinical problems, relative independence of decision making, time pressures, management of uncertainty, new practice systems, financial and billing issues – this challenge is likely to be exacerbated for many IMGs.
It is essential that the supervisor of IMG GPRs is willing to take on this broad responsibility, and to be overt about their support role in all aspects of the registrar’s development.

Foster a culture of learning and feedback

It is vital to foster an open and honest culture of teaching, learning and feedback in the practice.
Supervisors should use a broad range of teaching methods and focus on skill development, rather than clinical knowledge. It may be necessary at times for the supervisor to have challenging conversations with the IMG GPR on sensitive areas like cultural norms and communication issues. Thus, it is critical for both supervisor and registrar to agree on a process for frank feedback, while also maintaining a culture of mutual support.

Provide comprehensive orientation

One of the key planks in effective supervision of the IMG GP registrar is provision of a comprehensive orientation at the commencement of the training term.
In addition to the usual clinical and administrative benefits, there is evidence that effective orientation of IMGs can increase their sense of professional identity, morale and belonging. IMG registrars are likely to benefit from discussion of Aboriginal and Torres Strait Islander culture, as well as Australian culture more broadly, and community support. This may also include an orientation to the IMG registrar’s partner and family.

Engage assistance early

Supervisors need to engage appropriate support from their regional training organisation, or elsewhere, when performance issues arise.
Performance issues for IMG GPRs are often complex and may require specialist input. Supervisors should therefore have a low threshold for seeking guidance from the registrar’s medical educator.


There are multiple issues related to cultural differences that are challenges for IMGs.  The culture of medicine varies enormously from one country to another. The Australian medical system is likely to be vastly different to that in which the IMG trained, in structure, funding, and complexity. It is important that the supervisor help them to build confidence in working within a new system without feeling overwhelmed.
IMG registrars have described the challenges of understanding Australian culture as a significant training issue, including aspects as diverse as dress codes, sexual practices, and alcohol consumption. It has been found that IMGs may at times impose their own cultural norms during a consultation. Conversely, racism and community acceptance have been identified as issues for IMGs.
IMGs may also need to develop cultural competence in managing patients from multiple cultural groups, reflecting the diverse multicultural nature of Australia.
Tips Icon
    • Ask your registrar about their previous medical practice.
      • How did they interact with patients?
      • Did they work as part of a team?
      • How did they interact with specialists and other care providers?
      • What was the ‘medical culture’ in their home country?
    • Ask your registrar whether any aspects of the Australian culture are particularly challenging for them in their interaction with patients.
    • Ask your registrar whether they have ever been subjected to racism and how they dealt with it.
    • Ask your registrar to reflect on their own ‘cultural lens’ i.e., their own unique personal worldview influenced by the cultures that nurtured them.
      • How might that impact on the approach to patients from other cultures?


Navigating Medicare
Managing Medicare Billing
Medicare Compliance
Professional and Ethical Practice
Communication Skills Toolbox
VIDEO: How do cultural values and perceptions impact on clinical care?


It is well known that some IMG registrars have significant language issues that may impact on satisfactory communication, both with patients and peers. This has clear consequences for clinical outcomes, examination performance and confidence.
Most IMGs will have English as their second (or third or fourth!) language, even though they may have been exposed to English as the language of instruction. IMG GPRs may struggle with fluency and structure, and comprehension of colloquial English. IMGs have also specifically identified that understanding Australian slang, idioms and mannerisms can be a challenge.
Specific scenarios that require the use of specific communication skills can also be challenging, for example communicating with children, managing the angry patient, saying no, breaking bad news, motivational interviewing, palliative care, and grief counselling.
Areas in which IMGs may have problems are:
  • Picking up patient cues (verbal and non-verbal)
  • Demonstrating empathy
  • Establishing rapport
  • Appropriately responding to difficult situations
  • Translating medical jargon into lay language
  • Clarity of written communications
Tips Icon
      • Ask your registrar what communication skills training they have done in the past, if any.

      • Employ a broad range of teaching methods to focus on communication skill development e.g. direct observation, role play, random case analysis.

      • Give explicit feedback on communication skill issues, including written English, even though it might be challenging.

      • Demonstrate your ‘spiel’ for explanation and management.

      • Encourage your registrar to use simple communication strategies in the consultation (see diagram 1).

      • Discuss non-verbal cues and their likely meanings in Australian general practice.

      • Discuss and role play situations where specific communication strategies may be required (as above).

      • Encourage reflective practice in your registrar i.e. ‘How well did I communicate in that consultation?

      • Encourage your registrar to watch local TV shows, read newspapers, see Australian films, attend local venues e.g. sports clubs or RSL (if comfortable) etc. to help refine their everyday English language skills.

      • Consider online learning courses e.g. Doctors Speak Up website13 or assistance from professional linguists/language teachers.

      • Provide useful phrases 


History taking skills
Writing quality referrals
VIDEO: Australian slang
Australian slang dictionary
Slang terms in the consulting room
Website: Doctors Speak Up
VIDEO: Doctors Speak Up website


The pass rate for Fellowship examinations is lower for IMGs, including in those assessments of applied clinical knowledge.  Even where knowledge may be reasonable, it has been observed that the application of clinical knowledge can be an issue for some IMGs. Below are some of the key areas in which IMG registrars may have clinical challenges:
  • History Taking – History taking can be compromised by language barriers, communication issues and cultural differences, such as a biomedical approach to asking questions of patients rather than a dialogue. It may also be culturally unacceptable to take sexual history of  patients of opposite genderor exploring social circumstances like intimate partner violence.
  • Physical Examination – In some cultures, physical examination is less commonly performed, or it may not be appropriate for a male doctor to examine a female (or vice versa). As well, more intimate examinations like a pelvic examination may be deemed culturally unacceptable.
  • Management Planning – This is another potential lacking area of clinical skill development for IMG GPRs. The role of the allied health practitioner might be unfamiliar to many IMGs, reflecting the medical culture and access to resources in which they trained.
  • Investigations – The rational use of investigations may be challenging for IMGs dues to challenges in effective history taking and examination, lack of a patient-centred approach, intolerance of uncertainty, and the influence of past training or clinical practice.
  • Prescribing – Prescribing is another recognised area of clinical skill development for IMG GPRs, with similar factors underpinning it.
Tips Icon
      • Ask your registrar about the nature of their past clinical experience i.e. range of demographics, presentations etc.

      • Help your registrar identify their learning needs and clinical knowledge gaps using appropriate methods e.g. clinical self-assessment tool, random case analysis.

      • Discuss local and national disease epidemiology.

      • Encourage use of appropriate clinical resources and guidelines e.g. RACGP Red Book, Therapeutic Guidelines, Health Pathways.

      • Focus teaching on rational use of tests and treatments.

      • Use the GPSA teaching plans for in-practice teaching on identified knowledge deficits.


History taking skills
Physical examination skills
Chronic disease management care planning
Rational test ordering
Rational prescribing guide


Registrars often struggle to facilitate an effective, organised, and time-efficient consultation with their patients. This is particularly the case for many IMG registrars, where the primacy of the general practice consultation may not have been a feature of their past training or experience.
Areas such as building the doctor-patient relationship, opening the discussion, understanding the patients perspective, sharing information, reaching agreement and providing closure may be challenging for many IMG registrars. 


Health Education, brief intervention and motivational interviewing
Patient centred care
Follow up and safety netting

Professional and medicolegal

Professional and ethical practice

Professionalism is another area which has been identified as a focus for skill development for IMGs. This includes issues such as setting boundaries, difficulties obtaining consent, reluctance to disclose errors, and interpersonal communication.



There is evidence that IMGs from some countries have a higher risk of malpractice claims and adverse findings than Australian trained doctors.29 Common themes of ‘at risk’ countries of training include English as a second language, and different medical education and health systems to Australia. Specific areas include opiate prescribing and managing drug seekers (including being able to ‘say no’). For example, some drug seeking patients see IMGs as a ‘soft target’ and will sometimes be aggressive to get their way. Many IMGs may struggle with how to decline prescription requests.



Teaching professionalism guide
Teaching professionalism FAQ
Professional and ethical practice teaching plan
Identifying and Managing Medico-legal Risks

Teaching and Learning

IMG registrars are known to have lower pass rates in Australian GP training. One of the many potential factors underpinning this relates to the approach to learning. Below are some of the key areas of teaching and learnnig that may be challenging for IMGs.
  • Cultural approaches to learning – Many cultures embrace a strong hierarchy in the educational process, in which the teacher is seen as an expert, rather than a facilitator of knowledge. In such settings, there is often much less emphasis on identification of the learners individual learning needs and self-directed learning. The IMG registrar may be less comfortable speaking up or challenging their teacher.
  • Exam Preparation – IMGs are known to have lower pass rates in postgraduate examinations than local doctors,  likely due to cultural issues, communication and English language skills, clinical skills and study techniques.
  • Oral examinations –  In many settings oral examinations are traditionally examiner led, rather than candidate-led, and IMGs may need to change their approach from passivity and be encouraged to speak confidently about what they know.
  • Feedback – Factors such as perceived power dynamics between teacher and learner, communication issues, attitudes towards critique, and potential vulnerability in evaluation may differ for IMGs. In many cultures, critique is not a usual part of day-today practice and can therefore be misconstrued as evidence of a serious failure, associated with loss of face, shame and embarrassment.
  • Help seeking – It is known that the approach to help seeking varies between cultures and can impact on learning. IMG registrars may not ask for assistance directly, but may instead more subtly ‘hint’ at problems. This may be overlooked or misinterpreted by the supervisor.


Planning learning FAQ
Supporting GP registrars with the AKT and KFP
Preparing GP registrars for StAMPS
Feedback guide
Feedback FAQ
A “Call for Help” List for Supervisors and Registrars
VIDEO: Socratic versus Confucian conceptions of teaching and learning
Video: Stages of competence


For many IMGs, personal stressors are magnified. Migration and displacement may mean the absence of family and community supports. IMGs have described relocation to rural areas as a particularly stressful time, commonly associated with separation from partners and isolation. Family concerns are thus common. IMGs may be subject to prejudice or racism, which understandably can have a major impact on wellbeing. As well, IMG GPRs may have to adapt to a sudden change in status (specialist to trainees).
Tips Icon
      • Get to know the story behind your registrar – their background and life.
      • Let the registrar know that you ‘have their back’ at all times.
      • Encourage participation in community events.
      • Encourage your registrar to have their own GP.


Planning learning FAQ
Supporting GP registrars with the AKT and KFP
Preparing GP registrars for StAMPS
Feedback guide
Feedback FAQ
A “Call for Help” List for Supervisors and Registrars
VIDEO: Socratic versus Confucian conceptions of teaching and learning
Video: Stages of competence

Date reviewed: 22 September 2023

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