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Quality GP training must be safeguarded during time of upheaval

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In last month’s edition of Australian Medicine, I wrote on the impact of the 2014 Federal Budget on medical education and training. Since then, it’s become increasingly clear that significant changes to the general practice landscape are pending, and the profession must ensure it is actively engaged to protect the quality of GP training.

Many will be aware that General Practice Education and Training is being absorbed into the Department of Health, ostensibly for cost-savings and efficiency in GP training.

The puzzle pieces of training – the Regional Training Providers and the structures governing them – have been thrown up in the air, with a competitive tender process to take place prior to the 2016 clinical year. It’s unclear yet whether the pieces will land in remotely the same place as they started.

Simultaneously, GP training is slated for funding cuts from multiple angles; directly, through reduced AGPT funding per place, and indirectly through loss of Federal funding for the valuable Prevocational General Practice Placement Program (PGPPP). The loss of PGPPP is significant also for a number of internship emergency medicine terms in some states, and for its overall effect on prevocational capacity.

So far, the Department of Health has been consulting widely. However, a number of important questions remain unclear. What structures will exist for professional oversight of the tender process and governance of training? What role will the learned Colleges, the Royal Australian College of General Practitioners and Australian College of Rural and Remote Medicine, continue to play? What constitutes appropriate engagement of universities and service providers in GP training?

GP trainees are rightly concerned about continuity of their training, the selection of applicants in 2015 in to an as-yet-unknown system of professional and educational governance and, ultimately, protection of the quality of the general practice apprenticeship training experience.

Above all, trainees seek assurances that reform of GP training will progress with the maintenance of high quality of training its primary goal.

There must be formal governance structures for ongoing professional GP leadership, rather than ad-hoc consultation, to ensure that training providers are not able to ‘compete’ at the expense of a quality apprenticeship model of training.

Current GP trainees need assurances that they will be able to continue training in the broad model that they began. Many choose their Regional Training Provider based on a relationship with a community or region and, particularly where this is an area of workforce shortage, these trainees must be supported to continue training.

Future GP trainees considering applying in 2015 will require an appreciation of the model in which they will be completing their future training.

For many trainees, it won’t be acceptable to apply for GP training on the assumption that models of training, geographic distribution, professional and educational governance may remain similar to the current model. Unfortunately, time is short for resolving these issues – applications open in March 2015.

More urgently, however, the roles of the learned Colleges must be clarified to enshrine their position as custodians of professional standards for the accreditation of training providers.

Now is the time for the Colleges to work together in the interests of GP training, and perhaps even embrace leading roles in areas of training governance that had drifted away from the profession in recent years.

Given these pending changes, and with such potentially wide-ranging reforms, it’s critical that the AMA and other stakeholders remain united in their engagement to protect quality GP training.

The Council of Doctors-in-Training is working hard to represent the interests of GP registrars during this challenging time.