Giving general practice the prevocational training program it deserves
Strange, is it not, that one of the major medical specialties in Australia cannot offer junior doctors the chance to find out more about that branch of medical practice before they choose their career direction. Imagine if it was surgery or anaesthesia.
Like all of my colleagues, I was surprised when general practice was left in this position after the Federal Government decided to axe the Prevocational General Practice Placements Program (PGPPP) in last year's Budget.
The loss of the PGPPP also undermined efforts to deliver more training and care in the community, despite universal acceptance that we need to supplement the traditional hospital-based approach to medical training if we are to properly equip our future medical workforce.
Some background: the PGPPP was the successor to the Rural and Remote Area Placement Program. It initially funded 280 twelve-week placements in 2005, and by the time it was closed down it was flourishing, funding 900 placements a year, with many more wanting to take part.
To be sure, the PGPPP was an expensive program, but the lack of warning about its closure was disappointing; the AMA and other stakeholders could have worked with the Government to reform the program and make it more cost effective.
One of the first initiatives of the AMA Medical Workforce Committee when it was established late last year was to respond to the Government's decision and develop a proposal to support more prevocational training in general practice for junior doctors. The result has been the Community Residency Program (CRP).
The principal aim of the CRP is to encourage more young doctors to choose a career in general practice. And for those who decide to work in other specialties, it will help them to understand and appreciate general practice, how it functions, and the role it plays in the health system.
Our proposal shares some of the features of the old PGPPP, but it could be delivered at significantly lower cost and with less bureaucracy.
We have deliberately chosen not to nominate specific participation targets, but instead have outlined a set of design and funding principles. Junior doctors would undertake rotations of up to 13 weeks in general practice, which would help them to experience life as a GP and improve their clinical experience.
When the PGPPP was lost, the AMA feared a decline in the general practice workforce overall, but especially in rural and remote areas, where community need for GPs continues to grow.
I was therefore pleased that the Independent Expert Panel − established to report on the public consultation and advice to Government on the redesign of the General Practice Rural Incentives Program – recommended last month that the Government re-introduce a program to provide junior doctors with a rural general practice experience as part of their prevocational training.
Our CRP proposal certainly meets the panel's recommendation. Let's hope Health Minister Sussan Ley sees it this way as well, for rural general practice and the profession as a whole.
The AMA believes the CRP is worthy of the Government's consideration as a way to invest in our future medical workforce, surely a more sensible approach than simply opening more medical schools.
Details of the AMA Community Residency Program for JMOs are available at https://ama.com.au/submission/community-residency-program
Published: 15 Jun 2015