2017 MCCC Registrar Handbook

Registrar
Handbook
2017
Respect Compassion Integrity Responsibility Innovation

1 General information .................................................................................................... 4
1.1 Glossary of Terms ............................................................................................................. 4
1.2 The role of Murray City Country Coast GP Training (MCCC) ............................................... 6
1.2.1 MCCC Vision ...................................................................................................................... 6
1.2.2 MCCC Mission ................................................................................................................... 7
1.2.3 MCCC Values ..................................................................................................................... 7
1.3 CEO welcome .................................................................................................................... 8
1.4 MCCC contact details ........................................................................................................ 9
1.5 Important resources ........................................................................................................ 10
1.5.1 Pivotal: MCCC’s Online Administration Platform ............................................................ 10
1.5.2 MeL: MCCC’s Learning Management System ................................................................. 11
2 MCCC’S educational approach ................................................................................... 12
2.1 The medical education team ............................................................................................ 12
2.1.1 Director of Medical Education & Training (DMET).......................................................... 12
2.1.2 Medical Educators (MEs) ................................................................................................ 12
2.1.3 Supervisors ...................................................................................................................... 13
2.1.4 Training Advisor Review Meeting ................................................................................... 13
2.1.5 External Clinical Teaching Visitor .................................................................................... 13
2.1.6 Registrar Liaison Officers (RLOs) ..................................................................................... 13
2.2 The education program .................................................................................................... 14
2.2.1 In-practice ....................................................................................................................... 14
2.2.2 Out-of-practice ................................................................................................................ 14
2.2.3 Your learning plan ........................................................................................................... 15
2.2.4 Intervention Programs ...................................................................................................... 15
2.3 Registrar and family support ............................................................................................ 16
2.3.1 Self-Care ........................................................................................................................... 16
2.3.2 Safety promotion and risk management ........................................................................ 17
2.4 Confidentiality and privacy .............................................................................................. 19
2.5 The AGPT program ........................................................................................................... 21
2.5.1 Professional recognition as a General Practitioner ......................................................... 21
2.5.2 The roles of the two Colleges (ACRRM and RACGP) ....................................................... 21
2.6 Choosing a pathway ......................................................................................................... 21
2.6.1 Training towards Fellowship of Royal Australian College of General Practitioners
(FRACGP)...................................................................................................................................... 21
2.6.2 Training for Fellowship of Australian College of Rural Remote Medicine (FACRRM) ..... 23
3 The registrar’s journey ............................................................................................... 25
3.1 Hospital Terms ................................................................................................................. 25
3.1.1 Mandatory Paediatric Training .......................................................................................... 25
3.1.2 Hospital Training (RACGP) / CCT (ACRRM) Requirements ................................................... 26
3.1.3 Hospital Registrar Education Program ................................................................................ 26
3.2 Practice ready .................................................................................................................. 26
3.2.1 Being Matched to a Practice .............................................................................................. 27
3.2.2 What to do prior to commencing a GP Term ...................................................................... 27
3.2.3 How to acquire provider numbers .................................................................................. 27
3.3 Recognition of prior learning ........................................................................................... 29
3.3.1 Recognition of prior learning without time credit .......................................................... 29
3.4 Commencement of Training ............................................................................................. 30
3.5 Practice Orientation ......................................................................................................... 30
3.6 Training Time Calculations ............................................................................................... 30
3.6.1 Full Time Training ............................................................................................................ 30
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3.6.2 Part Time Training ........................................................................................................... 31
3.7 Supervision Requirements ............................................................................................... 31
3.8 Patient Numbers .............................................................................................................. 32
3.9 Registrar training and consultation information (RCTI)..................................................... 32
3.10 Diversity of Practice Experience (RACGP Ruling) ............................................................ 32
3.11 GPT1, 2 & 3 (RACGP) or PRRT1, 2 & 3 (ACRRM) registrars .............................................. 32
3.12 Assessments .................................................................................................................. 32
3.12.1 Initial Assessment ........................................................................................................... 33
3.12.2 Formative Assessment .................................................................................................... 36
3.12.3 Exams ............................................................................................................................ 38
3.13 Training time cap ........................................................................................................... 39
3.14 Extension of training time .............................................................................................. 39
3.15 Fellowship ..................................................................................................................... 39
3.16 Subsidies and grants ...................................................................................................... 40
3.16.1 Registrar Subsidies ........................................................................................................ 40
3.16.2 Rural Procedural Grants Program ................................................................................. 40
3.17 Overseas Trained Doctors (OTDs) .................................................................................. 40
3.18 Complaint procedure ..................................................................................................... 40
4 Appendices ................................................................................................................ 42
4.1 Appendix A: Policies and forms ........................................................................................ 42
4.1.1 AGPT policies and forms ................................................................................................. 42
4.1.2 RACGP policies and forms ............................................................................................... 43
4.1.3 ACRRM policies ............................................................................................................... 44
4.1.4 MCCC policies, forms and documents ............................................................................. 44
4.2 Appendix B: Orientation .................................................................................................. 47
4.3 Appendix C: Registrar competency benchmarking ........................................................... 53
MCCC Registrar Handbook 2017 3

1 General information
1.1 Glossary of Terms
ACRRM
AGPT
AKT
ALS
AMS
ARST
AST
CBD
CCT
DMET
DoH
DRANZCOG
ETC
ECTV
ESP
EST
FACRRM
FARGP
FRACGP
GP
GPR
GPRA
GPS
Australian College of Rural and Remote Medicine
Australian General Practice Training
Applied Knowledge Test
Advanced Life Support
Aboriginal Medical Service
Advanced Rural Skills Training (RACGP)
Advanced Specialized Training (ACRRM)
Case Based Discussions
Core Clinical Training (ACRRM)
Director of Education and Training
Department of Health
Diploma of the Royal Australian College of Obstetricians and Gynaecologists
Education Training Coordinator
External Clinical Teaching Visit
Extended Skills Post
Extended Skills Term
Fellowship of Australian College of Rural and Remote Medicine
Fellowship in Advanced Rural General Practice
Fellowship of the Royal Australian College of General Practitioners
General Practitioner
GP Registrar
GP Registrar Association
GP Supervisor
GPT 1, 2, 3, 4 General Practice Term 1 - 4
HLO
IMG
JCCA
KFP
Hospital Liaison Officer
International Medical Graduate
Joint Consultative Committee on Anaesthesia
Key Features Problem
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LME
MBS
MCCC
MCQ
ME
MiniCEX
MSF
NGPSA
OSCE
OTD
PALS
PM
Lead Medical Educator (holds a Portfolio)
Medicare Benefits Schedule
Murray City Country Coast GP Training
Multiple Choice Question
Medical Educator
Mini Clinical Evaluation Exercise
Multi-Source Feedback
National General Practice Supervisors Association
Objective Structured Clinical Examination
Overseas Trained Doctor
Pastoral and Learning Support
Practice Manager
PRRT1, 2, 3, 4 Primary, Rural and Remote Training terms 1-4
RA
RACGP
RCA
REAPS
RFDS
RHE
RLO
RPL
RTO
SLO
SME
TA
TSO
Remoteness Area
Royal Australian College of General Practitioners
Random Case Analysis
Registrar Education and Practice Support Coordinator
Royal Flying Doctor Service
Regional Head of Education
Registrar Liaison Officer
Recognition of Prior Learning
Regional Training Organisation
Supervisor Liaison Officer
Senior Medical Educator
Training Advisor
Training Support Officer
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1.2 The role of Murray City Country Coast GP Training (MCCC)
MCCC has been accredited by RACGP and ACRRM to offer the AGPT Program.
With offices in Bendigo, Parkville, Warrnambool and Wodonga, and training posts located
throughout its footprint, MCCC focuses its education program on the preparation of doctors for
metropolitan, suburban, rural and remote general practice.
MCCC is governed by a Board of Directors and managed by a Chief Executive Officer. The Board is
drawn from a broad-based membership, including:
• Training practices within our training footprint.
• Universities with clinical schools within our training footprint.
• Victorian hospitals within our training footprint.
• GP Registrars Australia.
• Royal Australian College of General Practitioners.
• Australian College of Rural and Remote Medicine.
• GP Supervisors Australia.
The education program is developed and overseen by a Senior Medical Education Team, headed up
by the Director of Medical Education and Training (DMET) and including Regional Heads of Education
(RHE) from all four of MCCC’s regions.
1.2.1 MCCC Vision
Enhancing community health and wellbeing through leadership in general practice education,
training, research and workforce development.
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1.2.2 MCCC Mission
MCCC will provide high quality education and training programs for GP registrars, junior doctors
interested in careers as GPs and where relevant, other general practice professionals.
MCCC will partner with:
• General practices to support integration of education, training, research and clinical
governance as core elements of quality general practice.
• Universities, Primary Health Networks, Hospitals, State and Federal Governments and
Communities to plan for sustainable general practice workforces in our regions.
1.2.3 MCCC Values
• Respect • Compassion • Integrity • Responsibility • Innovation
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1.3 CEO welcome
Congratulations on choosing a career in general practice, and welcome to Murray City Country Coast
GP Training (MCCC). Our region encompasses the western part of Victoria, extending from the South
Australian border to Melbourne, and north to the New South Wales border near Corryong, taking in
a small area of New South Wales near Holbrook.
One of our great strengths is the high quality of our education and training program for registrars.
This is based on two key facets:
• Learning occurs in-practice, where your supervisors are committed to both formal and
informal teaching opportunities.
• Learning occurs out of practice (face to face and a range of directed learning activities),
facilitated and supported by our experienced team of medical educators.
As a registrar you are learning with a cohort of peers, enabling you to share your experiences,
support each other and develop collegiate networks that will remain throughout your career. In
addition to the support provided by the Medical Education team, your supervisors and your peers,
you will have regular meetings with a Training Advisor (TA), who will provide individual guidance and
mentoring. The Registrar Liaison Officer (RLO) is able to assist by providing information and is a
further resource for assistance. As an MCCC registrar you will also be well supported by the skilled
administrative team based in our four offices in Bendigo, Parkville, Warrnambool and Wodonga.
When you enter the AGPT program with MCCC, you enter a relationship of mutual obligation. We
will provide a range of programs and funding to assist you to become part of your profession and we
expect that you will treat that support with respect.
This relationship of mutual obligation involves a responsibility for you to:
• Make yourself familiar with the contents of this Registrar Handbook.
• Meet the requirements of the MCCC education program by fully participating in all
educational activities.
• Work with MCCC to ensure that administrative aspects of your enrolment with the
Department of Health are addressed and maintained.
• Treat MCCC staff, practice supervisors and staff, and, most importantly, the patients you
care for with courtesy and respect.
Greg McMeel
CEO
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1.4 MCCC contact details
General enquiries
Phone 1300 6222 47 (1300 MCCC GP) Fax 03 9999 4558
Metro West
Postal Address
Level 2, 369 Royal Parade
PARKVILLE VIC 3051
Street Address
Level 2, 369 Royal Parade
PARKVILLE VIC 3051
Phone 03 9999 4540
RHE
Dr Thanh Nguyen
thanh.nguyen@mccc.com.au
REAPS
Lynette O’Dwyer
lynette.o’dwyer@mccc.com.au
RLO
Dr Preeya Alexander
preeya.maharaj@gmail.com
North East
Postal Address PO Box 165
WODONGA VIC 3690
Phone 02 6062 3800
Street Address
Level 4, 111-113 Hume St
WODONGA VIC 3690
RHE
Dr Kate Davey
kate.davey@mccc.com.au
REAPS
Jo Hamilton
jo.hamilton@mccc.com.au
RLO
Dr Elizabeth Walker
walker_eli@yahoo.com
North West
Postal Address
Level 1, 10-16 Forest St
BENDIGO VIC 3550
Street Address
Level 1, 10-16 Forest St
BENDIGO VIC 3550
Phone 03 4444 2300
RHE
RLO
Dr Rachel Lee
rachel.lee@mccc.com.au
Dr Carolyn Siddel
carolyn.siddel@hotmail.com
REAPS
Lyn-Marie Richards
lynmaree.richards@mccc.com.au
South West
Postal Address PO Box 5010
WARRNAMBOOL VIC 3280
Phone 03 4505 2600
RHE
Dr Eldon Lyon
eldon.lyon@mccc.com.au
Dr Margaret Garde
margaret.garde@mccc.com.au
Street Address
REAPS
Level 1, 49 Kepler St
WARRNAMBOOL VIC 3280
Jannah Wright
jannah.wright@mccc.com.au
RLO
Dr Myuri Kantharajah
myuri1603@gmail.com
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1.5 Important resources
The following websites provide valuable resources to inform you about your rights and
responsibilities within the AGPT program.
www.agpt.com.au
www.acrrm.org.au
www.gpra.com.au
www.gpsa.com.au
www.mccc.com.au
www.racgp.org.au
Australian GP Training Program website
Australian College of Rural and Remote Medicine
GP Registrars Association
GP Supervisor Association
Murray City Country Coast website
Royal Australian College of General Practitioners
1.5.1 Pivotal: MCCC’s Online Administration Platform
MCCC has introduced an online registrar information management system called Pivotal. It has tools
to assist you in developing a learning plan, links to resources and provides information to you, your
supervisor and your training advisor. You can access Pivotal from the MCCC website –
www.mccc.com.au. Your username and password will be sent to you by email early in your training.
1.5.1.1 Support for Pivotal
• Help files will be available on the MCCC website.
• Training activities will form part of your orientation program.
• MCCC admin staff will provide one-to-one support in person, over the phone and by screen
sharing.
Pivotal provides registrars with access to a web-based learning planner. An advantage of using this
learning planner is that it is a permanent on-line record that can be viewed by your supervisor and
MCCC's medical educators, such as Training Advisors. Registrars are entitled to use means other
than the Pivotal Learning Planner to plan and document their learning. However, registrars must
ensure that their plan for learning can be submitted to MCCC as an electronic document (e.g. a
Word document, an Excel spreadsheet, a readable scanned document of a hand-written document,
etc.).
Contact the MCCC office if you experience difficulties with Pivotal or forget your login details or
email pivotal@mccc.com.au.
Important correspondence is sent from MCCC to registrars and entered through
this platform.
Please ensure your address, phone and email details are always current on Pivotal
throughout your training.
This is also essential for MCCC when pre-populating and printing your provider
number applications.
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1.5.2 MeL: MCCC’s Learning Management System
MeL is MCCC’s learning management system. This is where you will find:
• Learning resources.
• Pre- and post-workshop activities.
• Assessment tasks.
• Policies, procedures and forms in the MCCC Vault.
1.5.2.1 Accessing MeL
• Login via the MCCC website, using the MyMCCC button.
• Through your Pivotal portal.
• Go there directly via http://mel.mccc.com.au.
Your username and password will be emailed to you early in your training.
1.5.2.2 Support for MeL
• Introduction in your orientation program.
• Email: mel@mccc.com.au.
• Call: 03 5562 0051 and ask for MEL Help.
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2 MCCC’S educational approach
MCCC’s AGPT program is based on the traditional teacher-student or apprenticeship model of
training developed over many years by RACGP and ACRRM. This on-the-job regime involves you
working as an independent member of a practice’s medical team under the supervision of an
accredited supervisor. The level of supervision is matched to your experience and learning needs.
On-the-job (or in-practice) teaching and learning is augmented by the out-of-practice learning
program. MCCC does not consider in-practice and out-of-practice learning as separate domains,
rather that they are inexorably entwined, with registrars learning at work, from work, and for work.
MCCC’s approach to education is shaped by the following educational theories:
• Work-based learning.
• Situated learning.
• Experiential learning.
• An epistemology of practice.
• Transformative learning.
• Self-directed learning.
Education with MCCC is supported by a strong team culture where learning is a shared experience
between you and the greater medical education team, including medical educators, supervisors,
other practice staff, the Primary Health Care Network and your peers.
2.1 The medical education team
2.1.1 Director of Medical Education & Training (DMET)
The Director of Medical Educator & Training (DMET) works closely with all members of the medical
education team, the Chief Executive Officer (CEO) and Chief Operations Officer (COO), the
administration team, the Board and other stakeholders to ensure the education and training
provided by MCCC meets the standards of both colleges, the requirements of the greater primary
health care network and the needs of you, the registrar.
2.1.2 Medical Educators (MEs)
Our experienced and qualified Medical Educators have various educational roles within MCCC
including:
• The planning, implementation and review of the out-of-practice component of your learning.
• Assisting you to develop and maintain an active plan for learning.
• Sharing their skills, knowledge and experience.
• Working closely with your supervisors and the greater education team, to support your
learning across the entire program.
Medical Educators may also be Training Advisors or supervisors within a practice.
MEs are organized into four regional teams, each with a lead Regional Head of Education (RHE). The
DMET and RHEs work as part of a senior team to maintain the quality of education across the
organisation.
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2.1.3 Supervisors
Supervisors play a key role in registrar training. Your supervisor is an experienced general
practitioner who works in a practice or post that has been accredited by either College. Your
supervisor will provide on-the-job teaching, supervision and advice in line with the standards set by
the RACGP and ACRRM. Details of the RACGP and ACRRM standards can be found on the respective
college websites.
A schedule of accredited general practice supervisors, practices and other training posts in MCCC’s
region can be found on the MCCC website.
2.1.4 Training Advisor Review Meeting
You will be allocated a Training Advisor to support you during your training. The contact might occur
face-to-face, via telephone or other interactive technology. The role of the training advisor is to:
Help you to develop a whole of training career plan that addresses both clinical development and
personal wellbeing when career choices are being made.
Assist you in completing applications for Recognition of Prior Learning (with or without time credit).
Oversee the development and review of your individual and specific learning plan and recording of
those on Pivotal.
Provide mentorship / career guidance.
2.1.5 External Clinical Teaching Visitor
During your general practice terms you will receive a minimum of five (5) External Clinical Teaching
Visits (ECTVs) conducted by a medical educator or an experienced GP supervisor. There will be at
least two (2) visits per semester for GPT/PRRT 1&2 and one (1) per semester for GPT/PRRT3. Visits
may continue into GPT4 as required.
During ECTVs the medical educator or visiting supervisor will observe you consulting in your practice
and provide feedback and assist you to identify your learning needs. A written report will be
available to you, your supervisor and your Training Advisor.
2.1.6 Registrar Liaison Officers (RLOs)
MCCC appoints a number of registrars as Registrar Liaison Officers (RLOs). RLOs maintain regular
contact with GP registrars and facilitate their input into future development, implementation and
evaluation of the training program.
The RLO can be a point of contact for registrars who have questions or concerns regarding their
training. They are also a link to, and are able to represent local registrars to, General Practice
Registrars Australia (GPRA). There will be an RLO in your region whom you can contact via email
(your regional office will provide details). You may also see them at your workshops.
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2.2 The education program
The AGPT program comprises both in-practice and out-of-practice learning and teaching
opportunities.
2.2.1 In-practice
The MCCC in-practice education program includes all teaching and learning that happens in the
training post. The in-practice program provides significant learning and teaching opportunities
including:
• Planned teaching sessions: one on one and small group.
• Ad hoc teaching (colloquially known as ‘corridor teaching’ or ‘teaching on the run’) (see
Morrison, Clement, Brown, & Nestel, 2014).
• Consultations with patients.
• Working with your supervisor and other practice staff to develop and action your learning
plan.
• Contributing to educational events targeted at local communities, organised by your
practice.
• External Clinical Teaching Visits (ECTVs)/MiniCEXs/Case based discussions.
• Training Advisor review meetings.
• In-practice assessment, feedback and monitoring.
As the deliverers of in-practice (on-the-job) teaching and supervision, GP supervisors and the
practice supervision team are the core to successful general practice training.
2.2.2 Out-of-practice
The out-of-practice learning program includes learning and teaching that occurs in the following
domains:
2.2.2.1 Face-to-Face
Teaching and learning that happens in person in the same physical space or supported by the use of
real-time technologies. This might include: workshops, study groups, one-on-one coaching and
mentoring and synchronous on-line learning.
Please note: There is a schedule of compulsory workshops. MCCC provides a detailed calendar of
these workshops and other significant training events and dates. The education calendar is updated
regularly and should be consulted frequently. It can be found on the MCCC website.
2.2.2.2 Directed Learning
Prescribed teaching and learning activities that you complete at your convenience. Directed learning
may include pre-reading, background research, completion of online modules and review and
reflection.
Please note: Directed learning activities might have a short timeframe (e.g. reading to be completed
MCCC Registrar Handbook 2017 14

prior to a workshop) or a longer timeframe (e.g. an online module that must be completed by the
end of a general practice term). In either case, you will be aware of the deadlines and critical dates in
advance.
2.2.2.3 Self-directed learning
You will take the initiative in identifying and meeting your learning needs by implementing
appropriate learning strategies. Self-directed learning activities will include the creation and
maintenance of your active plan for learning which will include: reflection on learning needs, goalsetting,
reviewing and updating a learning plan, attending an external course to meet an identified
learning need, studying for examinations, and ongoing evaluation to ensure you are meeting your
learning goals.
Please note: The scope of the RACGP and ACRRM curricula and the diversity of interests that
registrars bring to the program mean that the major focus of the MCCC education program is on selfdirected
learning. The principle of self-directed learning is that the overall responsibility lies with you
to plan your learning during your training. Workshops and other activities will only be able to
address part of the curricula. You will need to address the gaps through your practice-based learning
and your independent study.
2.2.3 Your learning plan
A learning plan and, for ACRRM registrars, a logbook are crucial to your success as a self-directed
learner. Both Colleges require you to develop and maintain a learning plan and a logbook of
activities for presentation as part of your application for fellowship at the conclusion of your
training. Consequently it will be important to begin work on it as soon as possible and to ensure that
it is documented on Pivotal (and on RRMEO for those enrolled with ACRRM).
Your Training Advisor and Supervisor can assist you to develop and maintain your learning plan and
log book. You will need to present these from time to time and will need to keep them up to date.
They will need to be lodged for final review at the time of your completion of training paperwork.
2.2.4 Intervention Programs
MCCC’s approach is to assist registrars as much as possible to enable them to achieve their learning
goals and to meet training, education and assessment requirements. Key elements of this policy
include the early detection of and support and focused intervention for reviewing problems and
difficulties. This occurs by applying fair and transparent processes of review throughout training.
During your time with MCCC there will be ongoing teaching, supervision, assessment and feedback.
It is possible that at some stage a specific problem may be identified with a registrar’s progress and
competency.
When a problem is identified, actions may include (but are not limited to):
• A meeting with a Medical Educator and your supervisor to develop strategies to deal with
the issue.
• Following this, a focused learning intervention plan with agreed learning outcomes may be
formulated.
• If the identified learning needs require further intervention, you may be required to undergo
formal remediation as required under the AGPT Remediation policy.
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2.3 Registrar and family support
MCCC acknowledges that the transition to general practice can be challenging, from both a
professional and personal point of view. To assist you with this process, MCCC offers the following
resources:
• Your Supervisor and Practice Manager.
• Registrar Education and Practice Support Coordinator (one per region).
• Registrar Liaison Officer.
• Training Advisor.
2.3.1 Self-Care
MCCC believes self-care is essential for a practicing GP. Doctors support their patients’ health and
wellbeing but often neglect their own. In order to assist our registrars and promote general
wellbeing and functionality, MCCC includes the topic of self-care in its workshop programs. MCCC
also provides a Registrar Assistance Program that enables you to access services. Please discuss this
with the RHE in your region.
There are many ways for registrars to seek assistance if experiencing difficulty in any aspect of
training or from a personal perspective, and we strongly encourage you to do so.
2.3.1.1 Other resources
Victorian Doctors Health Program
A confidential compassionate service for doctors and medical students (or anyone concerned about a
doctor) with health/drug and alcohol/mental health concerns. It operates independently from any
other organisations. Tel: (03) 9495 6011
Doctors’ Health Advisory Service
Independent service with calls handled by a panel of senior GPs experienced in helping colleagues.
Tel: (03) 9349 3504 (VIC) or (02) 94376552 (NSW)
Bush Crisis Line
Confidential and anonymous phone debriefing and counselling support service for remote health
practitioners and their families. Run by qualified psychologists with rural/remote and cross-cultural
experience. Tel: 1800 805 391
AMA Victoria Peer Support Service
Peer support for doctors – telephone counselling and referrals.
PO Box 21, Parkville, VIC, 3052 Tel: 1300 853 338
RACGP Support Program for members
Members can access professional advice to help cope with life’s stresses, which may include
personal and work related issues that can impact on their wellbeing, work performance, safety,
workplace morale and psychological health.
The service will advise of town location of the office addresses when ringing the number. The service
is provided by IPS Worldwide.
IPS Worldwide ®
Level 25, 303 Collins Street, Melbourne, VIC, 3000
Tel: 1300 366 789
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2.3.2 Safety promotion and risk management
2.3.2.1 Introduction
Although you are not employed by MCCC, the organisation has a responsibility to ensure that your
safety and wellbeing is promoted and risk factors are minimized as far as practicable. MCCC’s
Registrar Agreement details particular responsibilities for both the organisation and registrars
enrolled with MCCC.
Registrar wellbeing is an intersection of the responsibilities of MCCC, accredited training posts, and
the individual registrar. As employers of registrars, training posts have occupational health and
safety obligations that are governed by Federal and State legislation. Both ACRRM and the RACGP
set standards to ensure the occupational health and safety of a practice team 1,2 . Specific sections of
The National Terms and Conditions for the Employment of Registrars (NTCER) similarly addresses
issues related to the health and safety of registrars 3 .
2.3.2.2 Registrar Disclosure of Risk Factors
Acting on the advice of the Victorian WorkCover Authority, MCCC seeks to ensure that the following
statement is disseminated widely:
Registrars are strongly advised to disclose and discuss with their supervisors any medical condition
that might place themselves, or their patients, at risk. This is particularly important in view of the
work patterns of registrars in different hospital rotations and general practice attachments.
Different shifts, rosters, after-hours and on-call duties are all aspects of the work that you need to be
aware of and manage effectively. Discussion with supervisors will enable appropriate strategies for
management of the work environment to minimize the potential for harm to yourself or your
patients.
2.3.2.3 Fatigue Management
MCCC recognizes that fatigue is a potential workplace hazard that can affect your training. Fatigue
has many implications for you personally, your ability to meet your education and training
requirements and your capacity to provide safe, quality care for your patients.
Further information and management strategies can be found in these publications:
• GPRA (2012) Fatigue Management in Vocational General Practice Training.
• Safe Work Australia (2011) Preventing and Managing Fatigue in the Workplace.
2.3.2.4 Registrar Safety Training
Training in safety matters for registrars includes:
• Recognizing high risk situations.
1 Australian College of Remote & Rural Medicine. (2013). Standards for supervisors and teaching posts. Brisbane: Australian
College of Remote & Rural Medicine.
2 Royal Australian College of General Practitioners. (2010, updated 2013). Standards for general practices (4th edition).
East Melbourne: Royal Australian College of General Practitioners.
3 GPRA/GPSA/AMA (2014) The National Terms and Conditions for the Employment of Registrars (NTCER) 2015 & 2016 GP
Training Years.
MCCC Registrar Handbook 2017 17

• What to do when feeling unsure or unsafe.
• Dealing with angry patients.
• Dealing with drug-seeking patients.
• Personal self-care.
Matters relating to your safety are included in appropriate parts of the educational program.
2.3.2.5 Safety in the Clinic
There is a diversity of practices across the MCCC footprint. Consequently, in-practice safety
procedures vary. It is essential that you familiarize yourself with the procedures in your own
practice. This will be clarified during your in-practice orientation.
2.3.2.6 Safety After-Hours
As above, there is a diversity of practices and after-hour requirements. Your practice will have a
procedure to ensure your safety in regard to after-hours work. It is essential that you familiarize
yourself with this procedure.
2.3.2.7 Resources
These publications provide some useful guidance:
• Clode, D. and Boldero, J. (2005) Keeping the doctor alive: A self-care guidebook for medical
practitioners. Royal Australian College of General Practitioners, South Melbourne.
• Rowe, L., Morris-Donovan, B. and Watts, I. (2009) General practice – a safe place: tips and
tools. Royal Australian College of General Practitioners, South Melbourne.
2.3.2.8 Safety on the Road
While enrolled on the AGPT program, most, if not all, registrars will spend time driving. This may be
to and from work, to workshops, or to other meetings facilitated by MCCC as part of your training.
MCCC recognizes that long distance driving poses a risk to registrar safety and consequently we
discourage registrars from long-distance commuting and strongly advocate that registrars live in the
community in which they work. Fatigue exacerbated by driving long distances is a significant risk to
the registrar, patients and the training post, for which the registrar bears the largest responsibility.
The Code of Conduct for Doctors in Australia states clearly that, “good medical practice involves
recognizing and taking steps to minimize the risks of fatigue” (p.16) 4 .
2.3.2.9 Safety at ‘Out-of-Practice’ Educational Events
Your wellbeing at mandatory out-of-practice educational events (e.g. workshops) is the prime
example of where health and safety responsibilities intersect, especially in relation to fatigue.
Training posts, particularly in rural Victoria, may be a significant distance from the training venue.
The NTCER is clear that a registrar’s roster should consider the issue of fatigue in relation to the
4 Medical Board of Australia (2014) Good Medical Practice: A Code of Conduct for Doctors in Australia. Melbourne, Medical
Board of Australia.
MCCC Registrar Handbook 2017 18

distance that a registrar needs to travel to attend “educational releases” (section 16), and that a
registrar should discuss fatigue management with the relevant person at the practice. Some
safeguards might be: not being on-call the night before a workshop and allowing travel time to and
from a workshop during work hours if the distance to be travelled is significant.
In 2017, registrars who are required to travel more than 80 km from their practice to a workshop
may be offered accommodation paid for by MCCC. This is the case whether a workshop is scheduled
for one or more days.
At the end of a workshop a registrar may be eligible for an additional night of funded
accommodation if travelling home poses a risk to the registrar’s safety.
Eligibility may depend on:
• Seasonal considerations (i.e. the amount of daylight).
• The distance to be travelled.
• The number of people travelling together to the same or close-by destination.
• Arrangements with the registrar’s training post.
It is the registrar’s responsibility to initially discuss requests for paid accommodation with the
relevant local Workshop Coordinator. (Note that MCCC does not pay registrar travel
time/mileage/reimbursement to workshops or other educational events.
If an eligible registrar requests workshop accommodation and then does not use it or cancels it, the
registrar may be required to reimburse MCCC for any costs incurred.
2.4 Confidentiality and privacy
Confidentiality and privacy are used interchangeably in everyday talk, but they have distinctly
different meanings from a legal standpoint.
Definitions
Confidentiality
Privacy
Confidentiality refers to personal information shared with another person that
typically cannot be divulged to a third party without the consent of the first
individual. It is expected that information that is ‘held in confidence’ will only
be shared after authorisation is provided, and only to authorised individuals.
Privacy refers to the freedom from intrusion into one’s personal matters and
personal information. The boundaries around privacy are not tight, but include
information or opinion about a person’s:
• State of health.
• Racial or ethnic origin.
• Political, philosophical or religious opinions, beliefs or affiliations.
• Membership of a professional or trade association or union.
• Sexual preferences or practices.
• Criminal record.
These are categories of ‘sensitive information’ under the Privacy Act 1988
MCCC Registrar Handbook 2017 19

Personal
information
Information, or an opinion, about an individual, whose identity is apparent, or
can be reasonably ascertained from that information or opinion, whether the
information or opinion is recorded in a material form or not.
MCCC is committed to complying with Australian Privacy Principles, given in the Privacy Act 1988,
and the privacy provisions of all applicable legislation (e.g. Privacy and Data Protection Act (Vic.)
2014). MCCC’s approach to confidentiality and privacy covers all personal information held by the
organisation, including personal information sourced from third parties. MCCC will only collect,
store, use and disclose personal information that it is permitted to by law.
All registrars will be provided with information in relation to their rights and responsibilities. This
text is a key means to this end. Information will be provided to registrars regarding their personal
information and what it will be used for. MCCC’s Registrar Agreement includes a privacy consent
form that registrars are given and asked to sign at the commencement of their general practice
training. Signing the registrar agreement allows MCCC to share training record information with
other individuals that are involved in a registrar’s training (e.g. MCCC’s Medical Educators or a new
supervisor).
Registrars will be assisted to access their information if required. Much of this information is
available to an individual registrar via MCCC’s administrative management system (Pivotal). MCCC
may need to deny access to information in accordance with the exemptions contained in the Privacy
Act 1988.
A release of information form will be completed and signed by the registrar if information is to be
sought from or provided to other agencies. Registrars may withdraw their consent at any time.
If MCCC collects sensitive information (as defined under the Privacy Act 1988) it will be treated with
the utmost security and confidentiality. MCCC will ensure that it is not collected for any purposes
other than those for which MCCC has obtained the individual’s consent, unless the law requires
otherwise, or other exceptional circumstances prevail as described under the Privacy Act 1988.
Where an individual chooses not to provide requested information, MCCC will advise that individual
of what impact this may have. MCCC will only disclose personal information in accordance with the
Privacy Act 1988. This means that personal information may be disclosed:
• For the purposes for which it is being collected, and for related purposes that the individual
would reasonably expect.
• Where consent to do so has been given by the individual.
• As part of the arrangements for training to be done by an outside organisation or individual.
• As required by law.
• Under other circumstances where permitted under the Privacy Act 1988.
In the course of its business and training activities, MCCC may need to disclose personal information
to relevant individuals and organisations. Unauthorized disclosure of, or access to, personal
information by MCCC employees, contractors or agents, will be regarded as a serious breach of
policy. Appropriate action (which may include disciplinary or legal action) will be taken in such cases.
MCCC takes all reasonable steps to ensure that the data it collects is accurate, complete and up-todate.
The personal information collected by MCCC will be protected and managed confidentially and
securely, and destroyed appropriately when no longer required.
MCCC Registrar Handbook 2017 20

2.5 The AGPT program
2.5.1 Professional recognition as a General Practitioner
Doctors wishing to be vocationally registered as a general practitioner in Australia must gain the
Fellowship of one or both of the Royal Australian College of General Practitioners (RACGP) or the
Australian College of Rural and Remote Medicine (ACRRM). The awarding of fellowship comprises
the successful completion of MCCC education program requirements and College-related
summative assessments.
Successful completion of the college’s examinations will not automatically lead to the awarding of
Fellowship. This will be dependent upon the successful completion of all MCCC training
requirements. The requirements will be acknowledged and signed off by the DMET.
The program offered by MCCC enables doctors to gain Fellowship through either or both Colleges.
This then enables doctors to become vocationally registered and consequently access full
Medicare Benefit Scheme rebates for patients from Medicare Australia.
2.5.2 The roles of the two Colleges (ACRRM and RACGP)
MCCC collaborates with both Colleges to ensure the education and training program meets
their Vocational Training Standards.
Please note:
• RACGP and ACRRM set the curricula.
• All MCCC training practices, training posts and supervisors are accredited to provide training
(this accreditation may be College specific).
• RACGP and ACRRM set the summative assessments.
In enabling you to meet the requirements of the Colleges, MCCC supports you to design an active
and relevant learning plan to address your own personal needs and aspirations. You also have the
opportunity to choose the qualifications that you wish to attain. Please note the information that
follows regarding these qualifications and pathways.
2.6 Choosing a pathway
Once selected into the MCCC training program you will need to decide on training with
either the RACGP or ACRRM or both. You MUST become a paid member of the relevant
College throughout your training.
A delay in doing so will result in the College not recognizing any training time prior to
your membership as part of your training time.
If you are an RACGP member and wish to undertake a 4th year of training (ARST) you
must be enrolled in FARGP.
2.6.1 Training towards Fellowship of Royal Australian College of General
Practitioners (FRACGP)
MCCC provides a comprehensive, high quality training program compliant with the requirements of
the RACGP curriculum.
MCCC Registrar Handbook 2017 21

The RACGP pathway is a three (3) year program that includes an initial hospital year, eighteen (18)
months of community-based general practice and six (6) months of training in a skills term relevant
to your GP Training (this can be completed in general practice). During this period, MCCC runs peer
learning workshops as well as working closely with GP Supervisors to ensure all GP registrars receive
appropriate experience, adequate teaching and mentoring.
2.6.1.1 Summary of Training Units and Terms Offered in RACGP Training
Component of training
Number of 13 week active
training units required
Length of training
Hospital training 4 52 weeks full-time
GPT1 2 26 weeks full-time
GPT2 2 26 weeks full-time
GPT3 2 26 weeks full-time
GPT4 in GP or Extended skills 2 26 weeks full-time
The above compulsory terms can then be complemented by one of the following elective terms:
Advanced Rural Skills Post 4 52 weeks full-time
Academic Post will count towards an
Extended skill
2 26 weeks full-time
2.6.1.2 Advanced Training terms
The AGPT Program provides opportunities for all registrars to undertake a range of advanced terms,
referred to as extended skills, advanced rural skills training (ARST), or academic posts. These are
ideal for registrars with a special clinical interest. In some cases these experiences can lead to
postgraduate qualifications.
The curricula of the FRACGP and FARGP have different requirements for elective training and rural
specialized training, but MCCC offers training packages that meet the requirements of these awards
which can be tailored to your particular needs or interests.
MCCC requires you to apply for Extended Skill posts a minimum of three (3)
months prior to your proposed commencement date in that post. Training time
in these posts will not be recognized unless pre-approved by MCCC.
From 2017 onwards a term in general practice must be completed prior to
commencing an Extended Skill with the following exceptions: DRANZCOG, JCCA
and the Diploma in Palliative Care.
2.6.1.3 Extended Skills Training
MCCC has a range of accredited Extended Skills Posts at various locations. These include (but are not
limited to):
• Aboriginal Health
• Mental Health
• Emergency
• Obstetrics & Gynaecology (Dip. Obs)
MCCC Registrar Handbook 2017 22

• Palliative Care
• Alpine Skills
• Small Town General Practice
• Correctional Medicine
• Paediatrics
• Sports Medicine
• Sexual Health/HIV medicine
• Forensic Medicine
• Family Planning
• Medical Education
2.6.1.4 Training towards Fellowship in Advanced Rural GP (FARGP)
The FARGP pathway is an additional non-vocational qualification that can be added to the three (3)
year RACGP pathway. It involves an additional year of training undertaking an Advanced Rural Skills
Training post (ARST) including mandatory learning modules and educational activities.
Registrars interested in training towards the FARGP are advised to discuss this with their training
advisor at the earliest opportunity.
The following ARST posts are offered through MCCC:
• Aboriginal Health
• Anaesthetics
• Mental Health
• Obstetrics & Gynaecology (DRANZCOG Advanced)
• Small Town General Practice
• Emergency Medicine
2.6.1.5 Academic Posts
MCCC is associated with a number of university campuses. Opportunities exist to become an
academic registrar within the training program. If you have an interest in this area, please contact
the MCCC office or speak to your Training Advisor. Further information can be located on the AGPT
website.
2.6.2 Training for Fellowship of Australian College of Rural Remote Medicine
(FACRRM)
MCCC provides training in rural and remote medicine. Many of our supervisors and medical
educators have a high-level of experience in providing extended generalist care in relatively isolated
settings, including small rural hospitals; providing procedural services in the fields of anaesthetics,
obstetrics and emergency medicine. MCCC is able to offer registrars unique training opportunities in
these fields and other areas relevant to rural practice.
ACRRM training is modular and flexible but does require registrars to undertake training in
accredited locations and complete required assessments during training.
In order for MCCC to optimally assist potential ACRRM registrars it is necessary for early meetings
with an ACRRM training advisor to take place. This is to plan the training journey and assist registrars
in completing their training in a timely way. Failure to do so may mean the registrar may not have
sufficient training time in AGPT to complete the ACRRM pathway and assessments.
The ACRRM training pathway is a four-year program. It consists of:
MCCC Registrar Handbook 2017 23

ACRRM VOCATIONAL PREPARATION PROGRAM FOR REGISTRARS
Core Clinical Training Primary Rural & Remote Training Advanced Specialized Training
12 Months 24 Months 12 Months
In an ACRRM Accredited Hospital
Terms:
General Medicine
Obstetrics & Gynaecology
Anaesthetics
General Surgery Paediatrics
Emergency Medicine
You can commence without O&G,
Anaesthetics or Paediatrics, but
they must be met during PRR
training
Minimum 6 months in
primary/community care.
Minimum 6 months in
hospital/emergency care.
Minimum 12 months rural/remote
experience in any of the following:
Rural Hospital Aboriginal Medical
Service Rural Generalist Practice
RFDS
Only one is required, of the
following:
Anaesthetics
Obstetrics & Gynaecology
Surgery
Population Health Remote
Medicine
Indigenous Health
Adult Internal Medicine
Mental Health
Paediatrics
Please note that these PRRT and AST terms can be undertaken in any order. It would be usual for
RPL to be awarded for CCT.
Recognition of Prior Learning (RPL) may be awarded by ACRRM for part of this training time. Please
refer to the section on RPL.
For more information, please phone ACRRM on 1800 223 226 or go to the ACRRM website at
www.acrrm.org.au. Please speak to your training advisor early if you are interested in this pathway.
You must be a fully paid member of ACRRM to access the required training modules and fellow
through this College.
Those registrars intending to follow the ACRRM pathway are encouraged to join ACRRM during their
hospital time. This is especially relevant to enable adequate time to complete the relevant ACRRM
assessment tasks, including the Procedural Skills Logbook.
The following Advanced Skills Training posts are offered through MCCC:
• Aboriginal & Torres Strait Health
• Anaesthetics
• Mental Health
• Remote Medicine
• Paediatrics
• Obstetrics & Gynaecology (DRANZCOG Advanced)
• Emergency Medicine
• Surgery (2 years)
• Adult Internal Medicine
• Population Health
MCCC Registrar Handbook 2017 24

3 The registrar’s journey
3.1 Hospital Terms
Before commencing training in general practice through either college, it is mandatory that registrars
will have completed a minimum of twelve (12) months full time equivalent (FTE) after internship or
successful completion of the AMC Part 2 examination in an appropriately accredited Australian
hospital setting.
During the hospital year of training, the registrar will be employed by the hospital or area health
service. The onus is on the registrar to find suitable hospital employment. MCCC cannot assist you in
finding employment in the hospital system; however MCCC staff are available to provide guidance
on the suitability of a particular post.
MCCC encourages registrars to undertake this hospital experience within its region wherever
possible.
Those registrars who are entering the training program after extensive experience in hospital
medicine may be able to gain recognition of this experience and exemption from the hospital terms
by applying for Recognition of Prior Learning (RPL). Registrars on either College pathway must
complete and submit their RPL documentation according to the relevant College’s RPL policy. MCCC
has resources available to assist you in applying for RPL, including your REAPS, your Training advisor
and the Medical Education team.
Parameters ACRRM RACGP
Core rotations
(min. 10 wks)
Medicine, Surgery and Emergency
College-required
rotations (min. 10 wks)
Paediatrics*
Anaesthetics and O&G
These can be obtained
during training.
Paediatrics (Mandatory)
Encouraged to have three rotations
relevant to general practice, to
provide adequate breadth of
experience.
Please note ACRRM registrars entering the program without Paediatrics, will be unable to change
into RACGP pathway at any stage during their training without completing this requirement. MCCC
highly recommends that a Paediatric term be undertaken prior to commencing training.
Registrars must also have completed one year of hospital rotations. Only rotations undertaken after
completing PGY1 or after completion of AMC Part 2 examination can be counted.
3.1.1 Mandatory Paediatric Training
Registrars must undertake hospital-based experience caring for a sufficient number of paediatric
patients prior to undertaking a term in general practice. Such posts must include a high proportion
of paediatric emergency attendances managed under appropriate supervision.
These posts are usually a hospital-based general paediatric post or a placement in an emergency
department with a significant load of at least 20% (RACGP) or 25% (ACRRM) of acute paediatric
presentations.
MCCC Registrar Handbook 2017 25

For further information, visit the relevant College’s Paediatric Policies.
3.1.2 Hospital Training (RACGP) / CCT (ACRRM) Requirements
Parameters
Hospital Training/Core Clinical Training (CCT)
Paediatric
Requirement
Completion paediatric training evidence form before commencing training.
Disciplines
Hospital Registrar
education program
Assessment
Reports
Training Advisor/
Review Meetings
Statement of Service listing all rotations dates and any leave taken in the
period.
Teleconferences/webinars as arranged.
Submit HMO assessment or hospital supervisor report at the end of each
rotation completed during hospital training/CCT year.
As required.
3.1.3 Hospital Registrar Education Program
MCCC has a cohort of registrars who are completing their hospital terms across all MCCC regions and
possibly in hospital settings across Australia. MCCC values the role of the hospital registrar as a
pathway into General Practice and as such, develops programs and strategies to assist in the
transition from the hospital environment to general practice.
The MCCC Hospital Registrar Program is for pre-general practice registrars who have not yet
commenced GPT1. If you are a Registrar completing your hospital terms, you will be required to
participate in the Hospital Registrar Education Program.
MCCC will make contact with you in February with further information and details regarding the
Hospital Registrar Education Program.
3.2 Practice ready
To be considered practice ready you need to:
• Have completed one (1) year of hospital rotations in addition to and after completing PGY1
or both parts of the AMC Part Two examination.
• Completed all core rotations in approved hospitals.
• Hold full registration for a period of 12 months.
• All RACGP candidates must have a current ARC-accredited CPR certificate when commencing
their GPT1 term, and proof must be provided. CPR is to remain current throughout training.
MCCC Registrar Handbook 2017 26

3.2.1 Being Matched to a Practice
Registrars are allocated to practices through a practice match process.
Registrars and practices are invited to apply for the practice match and confirm their participation in
the match. Registrars will be notified by email when the practice match commences, along with
guidelines and a list of available practices.
Registrars apply to practices and practices select registrars for interview. Following the interview
period which lasts approximately five weeks, registrars and practices submit their preferences and
the matching process is activated.
Notification of the practice match outcome is made to registrars and practices. Further matches will
be undertaken, as necessary.
Practice matching is a complex process that endeavours to address the requirements of practice
supervisors and registrars. There is no facility to accommodate registrar and practices making a
private arrangement for a placement.
Further information will be available before a match is opened.
3.2.2 What to do prior to commencing a GP Term
Once you have been matched to a practice, contact the practice manager and supervisor, at least
two (2) months before term begins. Ideally, meet face-to-face prior to commencing at your practice.
Discuss employment terms and conditions.
As soon as you are advised of your placement the following paperwork must be attended to:
3.2.2.1 Registrar to provide to Practice
• Current certificate of medical registration from Medical Practitioners Board.
• Proof of adequate current Medical Indemnity Insurance (including procedural if required).
• Provider number (refer below).
• 19AB Exemption, entitlement to Medicare benefits if appropriate.
• Tax File Number declaration form.
• Details of nominated superannuation fund and fund membership number.
3.2.2.2 Practice Manager to provide to registrars
• Contract and other appropriate forms for signing.
• Tutorial for practice software.
• Password for billing.
• Documents supporting VMO application process (where applicable).
3.2.3 How to acquire provider numbers
Prior to your first placement in general practice it is vital that you have a Medicare provider number
(a number specific to each site in which you will practice). This gives you access to Medicare
MCCC Registrar Handbook 2017 27

payments. Without it you cannot be paid. Medicare cannot and will not backdate applications
received after you have commenced work.
A fact sheet detailing the steps in this process can be found here: AGPT Provider Numbers
• These forms can take up to 28 days to process.
• You need a Provider number for every site that you practice in.
• If you change practices a new application is required.
• The Provider number has an expiry date and you must reapply as
required.
• Any delay may mean you are unable to commence work, as you cannot
bill Medicare.
• Applying and following up provider numbers is the Registrar’s
responsibility.
MCCC Registrar Handbook 2017 28

3.3 Recognition of prior learning
In order for RPL to be granted the following criteria must be met:
• As the applicant, you must have been unconditionally medically registered in Australia for the
entire period.
• RPL With Time Credit is only applicable after full registration.
• As the applicant, you must provide satisfactory documentation from the employing hospital
of your hospital experience relating to the period for which RPL is being sought, together with
references or supervisor reports where required.
Please note:
• Applications for RPL are made on the appropriate form, available from MCCC Administration
Staff.
• RPL applications should be discussed with your training advisor.
• Applications are assessed by MCCC medical educators according to AGPT, ACRRM and
RACGP guidelines.
• RPL can also be used for Extended Skill Training.
• RPL applications must include a portfolio of documentation to provide evidence of the
relevance of their prior learning to the learning objectives of training.
• RPL will only be approved by the RHE and DMET if satisfactory progression of training has been
demonstrated.
• The process for application of RPL differs for each college. MCCC staff will assist you with the
detail.
3.3.1 Recognition of prior learning without time credit
Recognition of Prior Learning without time credit is:
• RACGP specific.
• To ensure recognition is recorded of mandatory hospital rotations.
• Does not reduce training time.
• Can only be applied for post intern hospital training experience.
For further information please refer to the following documents:
RACGP:
Recognition of Prior Learning policy
Applying for Recognition of Prior Learning Guidance Document
ACCRM:
Registrars submit their application through their training provider. The training provider checks that
the application is complete and has the required supporting documentation. The training provider
then makes a recommendation for RPL and submits the application to the College.
• See ACRRM Policy 1.11.
MCCC Registrar Handbook 2017 29

• Apply for RPL after you have obtained a training position
• ACRRM RPL Application Form.
For further information, read the Fellowship Training Handbook.
3.4 Commencement of Training
The MCCC Calendar will soon be available in Pivotal, which provides information on current
semester dates. Information on out-of-practice workshops for the year will be made available on the
MCCC website.
3.5 Practice Orientation
A thorough orientation to your practice is essential. This is usually provided by the practice
manager, practice nurse and supervisor, and in most practices a combination of the three. Especially
for GPT1 registrars, the orientation process might occur over a series of days rather than all at once.
For GPT1 registrars, it is suggested that at least the first day in general practice be spent in
orientation, sitting in with supervisor consultations, and the first formal teaching session. You are
likely to need some time with the practice manager as well, to ensure paperwork (e.g. provider
number, prescriber number and insurance) is complete. Depending on your experience, a plan for
when you will see your first patients and the timing of bookings can be made.
Please see Appendix B for a detailed checklist of what you can expect in your practice orientation.
3.6 Training Time Calculations
All registrars commence their vocational training at 1.0 FTE and are supported to undertake full-time
training to obtain College Fellowship. Any arrangement for the provision of training at less than 1.0
FTE is subject to negotiation between a registrar and MCCC.
3.6.1 Full Time Training
Training requirements are mandated by the relevant College and AGPT. The full time registrar
training requirement is calculated at a minimum of twenty-seven (27) hours face to face
consultation time over a four-day period per week.
Work periods of less than three (3) consecutive hours, or of less than one (1) month in any one
practice will not be considered. Hours worked beyond this definition of full time will not be
considered.
Term
Minimum
Consulting face
to face
Teaching Time
(in paid time)
Educational
Release (in paid
time)
Admin time
(in paid time)
(Training time)
GPT1/PRR1 27 hours 3 hours 3.5 hours 2.5 hours
GPT2/PRR2 27 hours 1.5 hours 1.75 hours 2.5 hours
GPT3/PRR3 27 hours 0.75 hour 0 hours 2.5 hours
MCCC Registrar Handbook 2017 30

ES/PRR4/Elective 27 hours 0 hours 0 hours 2.5 hours
Please note: Full time training is different than full time employment. Full time employment is based
on the National Terms & Conditions for the Employment of Registrars (NTCER), which states full time
employment to be thirty-eight (38) hours a week averaged over four weeks. For further information
click on this link NTCER.
3.6.2 Part Time Training
RACGP specifies a minimum of 10.5 hours face-to-face consultation time over a two-day period. Work
periods of less than three (3) consecutive hours, or of less than one (1) month in any one practice, will not
be considered by RACGP.
Registrars seeking fellowship of RACGP cannot train at less than 0.3 FTE as per the College requirements.
Registrars seeking fellowship of ACRRM are not encouraged to train at less than 0.5 FTE per College
requirements.
Teaching time for GPT1 & GPT2 is a minimum of one (1) hour regardless of FTE. Participation in the
educational release workshops should be as per a full time registrar.
3.6.2.1 Part Time Training breakdown
Term
Minimum
Consulting
face to face
(Training
time)
Teaching time
(in paid time)
Educational
Release (in paid
time)
Admin time
(in paid time)
GPT1/PRR1 10.5 hours 3 hours pro-rata
GPT2/PRR2 10.5 hours 1.5 hours pro-rata
3.5 hours as per
F/T program
1.75 hours as per
F/T program
2.5 hour pro-rata
2.5 hour pro-rata
GPT3/PRR3 10.5 hours 0.75 hours 0 hours 2.5 hour pro-rata
ES/PRR4/Elective 10.5 hours 0 hours 0 hours 2.5 hour pro-rata
Please refer to the AGPT, RACGP and ACRRM policies for further information
3.7 Supervision Requirements
Term Onsite Availability Availability by phone
GPT1/PRR1: 1 st month
100% consulting time* 0%
GPT1/PRR1: remainder
80% 20%
GPT2/PRR2 50% 50%
MCCC Registrar Handbook 2017 31

GPT3/PRR3
25% 75%
ES/PRR4/Elective
25% 75%
*This is preferred but not mandated
3.8 Patient Numbers
Registrars workload needs to be monitored to ensure they are not seeing too many, or for that
matter not enough patients. It is anticipated that the step up to increased patient numbers will be
done in consultation with the registrar and supervisor.
Please refer to the RACGP policy for further information.
3.9 Registrar training and consultation information (RCTI)
Registrar workload is recorded in the monthly Registrar Teaching and Consultation Information
record (RTCI) in Pivotal. An overview of the RCTI process will be provided at the orientation
workshop. For more information on the RTCI process, visit the Pivotal website.
3.10 Diversity of Practice Experience (RACGP Ruling)
All RACGP registrars must have experience in more than one practice in their training. This will
involve a full six-month semester at another practice.
Any exemption from this requirement will need to be assessed on an individual basis by your local
RHE and the DMET, and will require substantiated evidence as to why the exemption is required.
Final approval will be given by the RACGP Censor. Please refer to the RACGP policy for further
information.
3.11 GPT1, 2 & 3 (RACGP) or PRRT1, 2 & 3 (ACRRM) registrars
These terms focus on the transition from tertiary care to primary care. Registrars will consolidate
and increase skills in the general practice environment. These terms must be in an accredited
teaching practice with MCCC over an 18 month (FTE) period.
Registrars receive direct supervision and teaching from the accredited supervisors. There is expected
to be a high level of supervision, graduated responsibility and an increasing patient load. An
orientation will be given at each new practice.
3.12 Assessments
The MCCC General Practice Learning Program features assessment that is formative in nature and
occurs throughout the program, and summative which is facilitated by the respective colleges.
Formative Assessment is embedded in the teaching and learning program, enabling feedback that is
timely, relevant and enhances learning. It will draw on a range of methods appropriate to context
MCCC Registrar Handbook 2017 32

and purpose, supporting continuous development of skills, knowledge and behaviours. The
assessment processes reflects the standards of both Colleges and the Department of Health. In this
GP Term
Ave
Patients
per Hour
Max Patients
per Hour
Min No Consults
FTE week*
Max No Consults
FTE week
GPT1 1 st 3 months 2-3 4 50 90
GPT1 2 nd 3 months 3-4 4 50 100
GPT2 3-4 5 60 110
GPT3+ 3-4 5 60 110
way, formative assessment will inform entrance to, and progression through, the different terms. It
also will allow opportunities for educational enhancements such as interventions, remediation and
extension to the learning activities and experiences for each registrar.
Summative assessment measures whether a particular level of competence or performance has
been reached at a particular point in time. Summative assessment is the assessment registrars
undertake with their chosen college (ACRRM or RACGP). Registrars undertaking joint pathways will
be required to pass the assessments of both colleges.
3.12.1 Initial Assessment
As part of the formative assessment program, you will be involved in an Initial Assessment Process.
The purpose of the Initial Assessment Process is for the Medical Education Team to work with you,
generating and collating information about your areas of strength, learning needs and capacity to
perform at an expected GPT1 level. This Initial Assessment Process includes the following activities:
• Consideration of your results in the Situational Judgement Test.
• Completion of a Multiple Choice Questionnaire (MCQ).
• Participation in a clinical scenario.
• DVD Consultation review.
• External Clinical Teaching Visit (to be completed in the first four (4) weeks of term).
• Early Supervisor Assessment (to be submitted by week 4 of term).
The information generated and collected will be used by the Medical Education Team to work with
you and guide your learning journey, including the level of supervision and support, and to assist you
to develop and actively use a relevant, documented plan for your learning.
3.12.1.1 Situational Judgement Test (SJT) Score
The SJT is a written paper assessing your clinical reasoning ability. You completed this as part of the
selection process. The Education Team will use your results to assist you in your learning and
planning for learning.
3.12.1.2 Multiple Choice Questionnaire (MCQ)
The MCQ provides an opportunity for you to provide evidence of your general practice declarative
MCCC Registrar Handbook 2017 33

knowledge and for the Education Team to continue to build a picture your capacity and learning
needs.
The MCQ will consist of seventy (70) questions and you will have ninety (90) minutes to complete
those questions. The MCQ will be completed online, in your own time, prior to orientation
workshop. You will have access to the online questions for seven (7) days, however, the MCQ is time
limited and once you have begun, the time will begin and cease after ninety (90) minutes. You will
receive feedback on completion of the MCQ with results against curriculum areas. You will need to
bring those results to your orientation workshop and you will have the opportunity to talk about
your results one on one with a Medical Educator.
You will receive further information from your regional office regarding dates, accessing the
questions and trouble shooting.
3.12.1.3 Clinical Scenarios
The clinical scenario is completed during the orientation workshop, and is an opportunity for:
• You to demonstrate your knowledge and skills relating to the scenario.
• The medical education team to gather information that will further contribute to
understanding your strengths and learning needs.
3.12.1.4 DVD Consultation Review
The DVD consultation is completed during the orientation workshop and involves you viewing a DVD
of a consultation. You will rate and document various aspects of the consultation and then discuss
your thoughts and issues with a Medical Educator. This activity allows you to further demonstrate
your knowledge, and for the Medical Education Team to continue to build an understanding of how
they can best support your learning.
3.12.1.5 External Clinical Teaching Visit (ECTV)
ECTVs are a learning opportunity for you to receive teaching and feedback on your consultation
skills. The first ECTV is completed in-practice during initial assessment. You will be visited by a
Medical Educator or experienced supervisor from a practice other than yours. They will observe a
series (approximately six) of your consultations. This initial ECTV visit will occur in the first four (4)
weeks of your time in practice. It is an excellent opportunity for you to talk with an experienced GP
and educator about your consultations and receive valuable feedback. The ECTV provides MCCC with
an opportunity to ensure that you are receiving the appropriate supervision required when you are
working in practice.
3.12.1.6 Supervisor Report
The supervisor report is completed in practice during initial assessment, and involves your primary
supervisor reviewing your performance via a combination of inputs. Your supervisor might choose
from a variety of methods to assess your performance, including direct observation, WAVE
consulting, completion of an observation checklist and case discussion. Your primary supervisor will
complete this report by the end of your fourth week in practice. Again, the purpose of this is to assist
you in identifying your learning goals and developing strategies to achieve those goals.
Please note you will receive further detailed information about each of these assessment
opportunities. This provides you with an overview of the process.
MCCC Registrar Handbook 2017 34

The Medical Education Team will use the information gathered through the initial assessment
process to ensure you have the appropriate level of supervision, assist you to develop an active
learning plan and guide your learning journey at MCCC.
MCCC Registrar Handbook 2017 35

3.12.2 Formative Assessment
Activity
Brief overview
GPT1/
PRR1
GPT2/
PRR2
GPT3/
PRR3
ESP/
PRR4
Initial
Assessment
The majority of this
assessment is completed
at Orientation. A
supervisor report and
initial ECTV is also
required
Completed
by the 4 th
week
ECTV
External
Clinical
Teaching
Visit
Apart from the Initial
ECTV, the remaining visits
are to be organised by
the Registrar.
Contact the ECT visitor on
the roster provided, for
your subsequent visits.
Two visits
per 6
months*
1 st ECTV to
be
conducted
within 4
weeks of
commencing
training.
Two visits
per 6
months*
One visit
per 6
months*
Additional
visits maybe
required at
the
discretion of
the Medical
Education
team.
MiniCEX
For 2016, formative
MiniCEX will be
undertaken by all ACRRM
registrars
Five required by the end of
PRRT Year One.
A total of nine completed
by the end of Year Two.
Supervisor
Feedback
Feedback provided to the
RTO on the registrars
progress.
A minimum of two (2) per semester
Registrar
Feedback
Feedback from the
Registrar about their
training
One per
semester
One per
semester
One per
semester
One per
semester
Training Advisor
Review Meeting
You will be allocated a
Training Advisor.
The TA will conduct a Review Meeting with each
registrar. The timing of these visits will be determined
on an individualised basis. Minimum one per semester.
Learning Plan
A Learning Plan is
developed with the
supervisor in MCCC.
A well maintained
learning plan is required
At the start of each semester
A specific ESP
Learning Plan is
developed with
the supervisor.
MCCC Registrar Handbook 2017 36

for completion of
training.
RRMEO Modules
Online learning modules
for ACRRM registrars only
Completion of four RRMEO modules during training
*FTE: part time registrars will have 2 visits per 6 month full time equivalence.
MCCC Registrar Handbook 2017 37

3.12.2.1 Formative MiniCEX
A minimum of nine (9) patient consults must be reviewed using the ACRRM MiniCEX form.
The nine consults must include a:
Minimum of five (5) physical examinations, each from a different body system.
Detailed history taking of at least one (1) new patient or detailed updating patient database
information on a returning patient (of at least medium complexity).
Reasonable range of types of consults, age groups and both genders.
The nine MiniCEXs must be conducted by a minimum of three (3) different reviewers.
For further criteria around these visits please visit the ACRRM website.
3.12.2.2 Arranging your External Clinical Teaching Visit (ECTV)
This visit is as previously described in the Initial Assessment section, however for these subsequent
ECT visits it is the Registrar’s responsibility to arrange these visits. Your practice manager may also
be able to help.
You will be given an ECT roster, allocating a visitor to you; it will have their preferred contact email.
Email your ECT visitor to arrange a suitable time, provide them with your work hours to help you
both find a suitable time.
Once your visit has been arranged, please email the TSO (details will be provided) with the date of
this visit. This will be uploaded to Pivotal.
A confirmation email will come out from the MCCC to all concerned, so your practice blocks out this
session accordingly.
Your practice will be asked to program your session with 30-minute appointments to allow for
discussion with your visitor. Please check this has occurred.
All your patients must sign Consent Forms (available on MCCC website) before their consultation.
Remind your reception team of this requirement on the day.
3.12.3 Exams
Eligibility to sit the appropriate College exams is not an automatic process. Each College has specific
requirements about time and core content completion that must be undertaken prior to enrolling
for the exams. The information about these requirements can be found on the respective College
websites.
Please discuss with your Training Advisor and your supervisor your readiness to sit exams. Refer to
Readiness to undertake an examination (RACGP).
Registrars will be expected to sit in the GPT3 / 4 year or PRRT3/4.
Please note: RPL WITHOUT time credit will not count towards the required hospital units needed to
sit. Refer to the College policies for further information.
Both ACRRM and RACGP run exam workshops.
3.12.3.1 Examination Preparation
MCCC Registrar Handbook 2017 38

MCCC’s policy is to assist you in becoming a competent GP. Assistance with exam preparation will be
provided by MCCC.
Details of what you need to do to enrol in the examinations and the dates when they will be held can
be found on the examination pages of the colleges’ websites, see the following links.
RACGP Exams
ACRRM Exams
3.13 Training time cap
It is expected that all registrars training on the AGPT Programme will achieve fellowship within:
• Four years from the commencement of training for full time registrars (RACGP).
• Five years from the commencement of training for full time registrars (ACRRM).
• Five years from the commencement of training for full time registrars (dual Fellowship or
FARGP).
Please refer to the AGPT Training Obligations Policy 2016 for part time limits.
3.14 Extension of training time
The GP Registrar has a limited number of extensions available to them under the program.
They consist of:
• Twelve (12) weeks’ extension for administration purposes (exams passed and paperwork
lodged).
• Six (6) months’ extension to undertake exams.
• Six (6) months’ extension for additional/related training (over and above the set program).
Please ensure you read the AGPT Extension of Training Time Policy as not all options are available in
all instances.
MCCC can only provide registrars extra training assistance during approved training time.
3.15 Fellowship
Both colleges have a policy or handbook to guide you through the fellowship process.
MCCC will be in contact when you are eligible to fellow to go through these requirements. Please
ensure all educational requirements have been met.
Fellowship is awarded not only on completion of College requirements but also those of MCCC.
• Vocational Training Pathway – Requirements for Fellowship Policy -RACGP
• Fellowship Assessment Handbook - ACCRM
MCCC Registrar Handbook 2017 39

3.16 Subsidies and grants
3.16.1 Registrar Subsidies
MCCC provides its registrars with a number of subsidies that are designed to assist them to meet
their responsibilities and to complete their educational requirements in achieving professional
recognition. Details of the current registrar subsidies paid by MCCC are available in TR00?? Registrar
Subsidies.
3.16.1.1 Accountability of MCCC and of Registrars
MCCC and its registrars have a responsibility to ensure that funds provided by the taxpayer are used
responsibly and appropriately. To this end, MCCC has developed an approach to providing financial
and other support to our registrars based on the principles that:
Any subsidies provided should be consistent with and reinforce policies designed to encourage
registrars to live and train in our region and to seek employment in the region after completion of
training.
Within these policies, payment of subsidies should be as equitable as possible to registrars wherever
they might be living or be placed within the region.
The payment of subsidies should require a minimum of administrative processes.
Subsidies should only be paid for expenses incurred as a direct result of the registrar’s participation
in the AGPT Program.
Where expenditure can be incurred at the discretion of the registrar, MCCC may require a
contribution from the registrar.
3.16.2 Rural Procedural Grants Program
Both RACGP and ACRRM have been contracted by the Department of Health and Ageing to
administer the Rural Procedural Grants Program (RPGP). It provides funding to assist GP
proceduralists in rural and remote areas to maintain and upgrade their skills.
Please go to the following websites for further information.
• Rural Procedural Grants Program (RPGP) RACGP
• Rural Procedural Grants Program (RPGP) ACRRM
3.17 Overseas Trained Doctors (OTDs)
The term Overseas Trained Doctor (OTD) is interchangeable with International Medical Graduate
(IMG). The term OTD will be used for the remainder of this section and for better understanding of,
and in compliance with, the Health Insurance Act 1973 (Cth).
For further information about 19AB Health Insurance Act and the 10 year moratorium, please go the
following link.
Fact Sheet - Section 19AB of the Health Insurance Act
3.18 Complaint procedure
MCCC Registrar Handbook 2017 40

Where a complaint or grievance arises and cannot be resolved informally, the TR0001 Complaint and
Appeals Procedures should be followed.
The Complaint Reporting Form should be used and is available for completion and submission via
Pivotal.
MCCC Registrar Handbook 2017 41

4 Appendices
4.1 Appendix A: Policies and forms
4.1.1 AGPT policies and forms
4.1.1.1 Program Policies
AGPT Program Policies 2017 - Overarching Document
AGPT Academic Post Policy 2017
AGPT Appeals Policy 2017
AGPT Complaints Policy 2017
AGPT Extension of Training Time Policy 2017
AGPT Program Leave Policy 2017
AGPT Remediation Policy 2017
AGPT Salary Support Policy 2017
AGPT Training Accessibility Policy 2017
AGPT Training Obligations Policy 2017
AGPT Training Region Policy 2017
AGPT Transfer Policy 2017
AGPT Withdrawal Policy 2017
4.1.1.2 Forms
Appeal Application
Deferral of Training Application
Exception to Training Obligations Application
Further Extension to Training Time Aplication
Notification of Withdrawal
Pathway Transfer Application
Program Leave Application
Remediation Application
Registrar Complaints Application
Subscription Application
Transfer Between RTO or Training Region Application
MCCC Registrar Handbook 2017 42

4.1.2 RACGP policies and forms
4.1.2.1 RACGP Examination policies
Fellowship Exams Candidate Handbook
Readiness to Undertake an Examination
4.1.2.2 Fellowship pathway policies
Applying for Fellowship of the RACGP via the Vocational Training Pathway
Applying for Recognition of Prior Learning Guidance Document
Assessment of General Practice Experience Policy
Paediatric Term Requirements
Recognition of Prior Learning Policy
Vocational Training Pathway – Examination Eligibility Policy
Vocational Training Pathway – Requirements for Fellowship Policy
Witnessing and Certification of Documentation Policy
4.1.2.3 Education Services exceptions policies
Educational Misconduct Policy
Education Services Appeals Policy
RACGP Examinations Special Consideration Policy
4.1.2.4 Forms
Application for Appeal
Application for Reconsideration
Application for Special Consideration
MCCC Registrar Handbook 2017 43

4.1.3 ACRRM policies
Fellowship Training Handbook (contains most ACRRM training policies)
Appeals Policy
Completion of Training Policy
Fellowship Assessment Handbook
Grievance Policy
Refund policy
Registrar Review Policy
Special Consideration for Assessment Policy
4.1.4 MCCC policies, forms and documents
4.1.4.1 Education policies
ED 0001 Education and Training Philosophy
ED 0002 Recognition of Prior Learning for ACRRM Registrars Policy and Procedure
ED 0003 Recognition of Prior Learning for ACRRM Registrars Policy and Procedure
ED 0004 Extended Skills Post Application Procedure
ED 0005 Registrar in Difficulty Procedure
ED 0006 Practice Readiness Policy and Procedure
ED 0007 Accreditation of Training Posts and Supervisors Policy
ED 0008 Registrar Wellbeing Policy
ED 0009 Extension of Training Policy and Procedure
ED 0010 Accreditation of ARST and AST Posts Procedure
ED 0011 Application to Undertake GPT4 in a Non-Accredited Practice Procedure
ED 0012 Out-of-Practice Education Attendance Policy
ED 0013 Registrar Critical Incident (Clinical) Procedure
ED 0014 Accreditation of Training Posts Using Blended Supervision Models Procedure
ED 0015 Therapeutic Relationships Policy
ED 0016 Practice and Supervisor Monitoring and Support Procedure
ED 0017 Withdrawal of College Accreditation Procedure
4.1.4.2 Training policies
TR 0001 Complaint and Appeals Procedure
TR 0002 Diversity of Training Experience Policy and Procedure
MCCC Registrar Handbook 2017 44

TR 0003 Training Obligations Policy
TR 0004 Transfer In To MCCC Policy and Procedure
TR 0005 Transfer Out of MCCC Procedure
TR 0006 Transfer Between Training Pathways Procedure
TR 0007 Practice Matching Policy and Procedure
TR 0008 Medicare Provider Number Procedure
TR 0009 Registrar Selection Procedure
TR 0010 Educational Funding for Registrars Procedure
TR 0011 Funding for New Practices
TR 0012 Metro West Outer Metro Training Requirements and Restriction Policy
TR 0013 Change of MCCC Region Policy
TR 0014 Leave from AGPT Program Procedure
TR 0015 Withdrawal Policy
TR 0016 Training Practice Funding Policy
TR 0017 Extension of Training Time
TR 0018 Completion of Training Procedure
4.1.4.3 ACRRM MiniCEX Supervisor Pack
Formative MiniCEX scoring form– Australian College of Rural & Remote Medicine
MiniCEX conducted by Supervisor – Guidance document – MCCC GP Training
Physical exam reference – Australian College of Rural & Remote Medicine
4.1.4.4 Assessment
Initial In-Practice Supervisor Report
4.1.4.5 Training
Application to change region
Application for Leave from AGPT
Application to Undertake an Extended Skills Post
Diversity of Training Experience Variation Procedure
Variation to RACGP Training Diversity Application
Variation of Training Time Application
4.1.4.6 External Clinical Training Visits
ACRRM MiniCEX Scoring Form
MCCC Registrar Handbook 2017 45

ECTV Feedback Form
ECTV Patient Consent
ECTV Supervisor Claim Form
Verbal Consent Form for Video Recording a Consultation
Video Recording Consent Form
4.1.4.7 Training Advisor Visits
MCCC Supervisor Claim Form – TA Visits
4.1.4.8 Feedback
Registrar Feedback Form for Registrars to provide feedback on the practice they work in. This form is
available on Pivotal.
Supervisor Feedback Form for Supervisors to provide feedback on the Registrar/s they supervise in
their practice. This form is also available on Pivotal.
4.1.4.9 Orientation
MCCC Orientation Checklist
4.1.4.10 Registrar claims for reimbursement
Registrar Claim for Relocation Reimbursement
Registrar Claim for Expense Reimbursement
4.1.4.11 Reviewing the progress of GP Registrars
Training Advisor Review Meeting
4.1.4.12 Complaints
MCCC Complaint Form
MCCC Registrar Handbook 2017 46

4.2 Appendix B: Orientation
Thorough orientation of the registrar to the practice is essential. This is usually provided by the
practice manager, practice nurse and supervisor (in most practices, a combination of the three).
For GPT1 registrars
For GPT1 registrars, the orientation process might occur over a series of days rather than all at once.
To qualify for the Registrar Orientation Payment the following orientation must be competed and
co-signed by the registrar. It can be submitted with the GPT1 initial in-practice performance
assessment form.
For GPT1 registrars, it is suggested that at least the first day in general practice be spent in
orientation, sitting in with supervisor consultations, and the first formal teaching session. The
registrar is likely to need some time with the practice manager as well, to ensure paperwork is all
complete (e.g. provider number, prescriber number and insurance). Depending on the registrar’s
experience, a plan for when they will see their first patients and the timing of bookings can be made.
Orientation to the Medical Practice
The Registrar’s role – reinforcing their role as an independent practitioner, with appropriate
consultation with the supervisor.
Professional Behaviour:
• Terms of address – patients/staff
• Privacy and confidentiality
• Punctuality
• Dress code
• Mobile phone/social media use and practice policy
• Overview of terms and conditions – working hours, remuneration, overtime
• Procedure for altering work hours, sick leave, annual leave
• Who to approach with questions/concerns (non-medical)
Practice Meetings – Doctors, Staff, CME
Who works in the practice/practice management:
• Welcome and introduction to staff including a list of staff names and positons
• Who is responsible for what?
• Practice Nurse: Procedures undertaken by nurse/immunizations
Tour of premises/Surgery hours:
• Where are medical supplies and stationery?
• Parking and access to the building in and after hours
• Tea room, where to leave bag, lunch arrangements
• Information regarding local area e.g. banks, shops, food outlets
In-Practice Teaching/Learning Plan/Release Days:
MCCC Registrar Handbook 2017 47

• MCCC workshop dates – when, booked in
• Discussion about ECTVs
• Arrangements for tutorials – when, where, who with
• Plan for learning
When/who to ask for assistance:
• Process for ‘corridor’ consultations, e.g. phone advice, calling-in, messaging systems, second
opinions, who can be approached, how and when?
• Arrangements for support in and out of hours
• Arrangements for threatening/unsafe situations
Equipment in Surgery/Doctors Bag:
• Practice resources/practice library
• Therapeutic Guidelines and use where available
• Other – e.g. internet, shared passwords to electronic online/offline resources
• Patient information resources
Telephone System:
• Use of lines, on-hold, transferring calls
• Communications between staff and doctors
• Policy for returning calls to patients
Reception Area/Office Equipment:
• In-tray/pigeon hole
• Document shredding/recycling
• Photocopier, fax, scanner
• Prescription box
• Front office use – appointments, accounts etc.
Computer System:
• Password, turning on, logging on, turning off
Consulting Room:
• Phone system – extensions, emergency calls
• Equipment – otoscope/ophthalmoscope, urine testing, sphygmomanometer
• Pathology supplies – pap kits, swabs, urine pots
• Waste – paper recycling, medical waste, sharps, laundry
• Duress alarms, how they work and who is alerted when activated
Practice Policy and Procedure Manual:
• Particular areas of importance to new doctor. E.g. Infection Control, sterilization
procedures, occupational health and safety, normal & abnormal results, threats,
evacuations.
MCCC Registrar Handbook 2017 48

Specific Practice Policies:
• Billing policy
• Protocol for dealing with the aggressive or violent patient
• S8 drugs/drugs of addiction
• Repeat prescriptions
• Telephone calls including results
• Grievance/complaints policy
• Patients without appointments
• Injuries including needlestick
Orientation to general practice systems
Emergencies:
• Ambulance
• Resuscitation procedures
• Emergency retrievals and advice
• Poisons information
Appointment System:
• Practice policy regarding appointments
Medical Records:
• Filing system and accessing records
• Computerized records
• Preferred method of record keeping
• Results – protocol for checking and filing
Billing Procedures:
• Common list of fees and item numbers
• Practice policy on private and bulk billing
• Commonly used procedures
• Various medicals, vaccines and dressings
• Medicare guidelines for rebates
• When and how to privately bill after hours
• Communicating billing to front office
• The use of EPC items
Pharmaceutical Benefits Scheme – PBS, Authority Scripts, Private, OTC
Workers Compensation/TAC
Pathology – Sample collection, preferred provider, blood pressure monitoring
MCCC Registrar Handbook 2017 49

Radiology Services – X-ray services, ultrasounds, bone density
After Hours:
• Roster
• How to open and lock-up the surgery/security system code
• Accessing medical records
• Weekend surgeries
• Billing after hours
Home Visits
Hospital(s) and Hospital admissions (include accessing VMO rights, specific details on
orientation to local rural hospital)
Nursing Home(s) and Aged Care:
• Aged Care Assessment Team
• Respite care
• Enhanced Primary Care Medicare Items
• Day Centre
• Referrals
Specialists
Community Nursing Service
Palliative Care
Diabetes Services:
• Diabetes Educator
• Dietician
• Podiatrist
• Diabetes Australia
• National Diabetes Supply Scheme
• Purchase of Blood Glucose Monitors
Dentists
Mental Health Services – Alcohol and Drug Rehabilitation
Cardiology Services
Other Allied Health Professionals:
• Audiology
• Counselling
• Occupational Therapy
• Optometrists
• Physiotherapists
MCCC Registrar Handbook 2017 50

• Podiatrists
• Psychologists
• Social Workers
• Fertility Clinics
Other
Shared Care – Antenatal/Diabetes
Termination of Pregnancy – Surgical/Medical
Child abuse – Mandatory Reporting
Medical Examinations: Non-Medicare, pre-employment, insurance, diving, commercial
Vehicle License
Medico-Legal Reports
Sexual Assault
Funeral Services
Orientation to the Local Community
Local Services:
Accommodation (if required)
Orientation to Local Hospital and/or Nursing Home if appropriate
Demographics of patients and community
Social activities in the community
Local Primary Health Network (PHN)
Other local sources of GP medical education
Pharmacies
Schools
Places of worship – churches, temples, mosques, etc.
Community Centre
Library
Community Service Groups
Orientation was provided to the registrar and the relevant items above were discussed:
Supervisor Name:
Signed:
Date:
MCCC Registrar Handbook 2017 51

Registrar Name:
Signed:
Date:
MCCC Registrar Handbook 2017 52

4.3 Appendix C: Registrar competency benchmarking
1.Introduction
1.1 Purpose
The following document serves as a synopsis of the Colleges (RACGP and ACRRM) standards required
of general practice registrars as they progress through training towards Fellowship. It has been
designed to contract the extensive number of required competencies cited in College documents in
to statements that are more readily useable in the medical education arena.
This work provides medical educators a meaningful and user-friendly summary of required
competencies that can be used when both designing assessments and when assessing registrar
performance.
The document assumes that a registrar at a more advanced level of training will have obtained the
skills described at the preceding level.
It is expected that a user requiring greater depth of information about a particular competency or
domain will use the links provided to refer to the Colleges’ parent documents.
For a visual summary of these competencies, please see the Core Competencies Spreadsheet.
1.2 Audience
The target audience for this synopsis is medical educators involved in the assessment of registrar
competency.
1.3 Definitions
Entry to GPT1/PRRT1
The number of hospital years a GPT1/PRRT1 registrar will have experienced varies greatly, though
the minimum number is two.
In commencing GPT1/PRRT1, registrars should recognise the difference between general practice
and other specialties, particularly the GP as the gatekeeper and coordinator of care, and the
community context of general practice. The registrar will then begin to apply and develop the skills
of general practice: the nature of general practice presentations, continuity of care, undifferentiated
illness, and the systems of practice. By the end of GPT1/PRRT1, registrars will be “just settled in”.
General practice under supervision: end GPT1-GPT2 and end PRRT1-PRRT2
During GPT2/PRRT2, registrars are comfortable with and use a wide range of general practice skills.
They become less reliant on their supervisor and work more independently and collaboratively. By
the end of GPT2/PRRT2 the majority of registrars will be ready to sit the College exam. Others may
need additional support to hone knowledge and skills. Exam preparedness does not equate to
readiness for vocational registration and unsupervised practice. By the end of GPT2/PRRT2,
registrars are well settled in to general practice.
At time of fellowship: GPT3-GPT4/ PRRT3-PRRT4
A registrar at time of Fellowship is exam-ready and has demonstrated enhanced knowledge. They
are proficient in their skills and capable of working independently and collaboratively.
MCCC Registrar Handbook 2017 53

2. Competency Benchmarks
2.1 Entry to GPT 1/PRRT1
Communication
skills: doctor- patient
and doctor – interprofessional
Has effective communication skills and uses language that is easy to
understand; is warm and sympathetic, establishes rapport and listens and
responds to verbal cues
Communicates effectively in written word (clinical notes and referral letters)
Identifies and manages patients who are angry, distressed; has a framework
for appropriately breaking bad news
Identifies patients whose care may be enhanced or undermined by
involvement of family members; can manage confidentiality and informed
consent
Recognises patients who benefit from health promotion, self-care and
counseling and appreciates barriers to implementing these strategies
Identifies culturally appropriate communication with both Aboriginal and
Torres Strait Islander peoples and those from culturally diverse
backgrounds and the role of Aboriginal and Torres Strait Islander cultural
educators and mentors; appreciates impact cultural beliefs, behaviours and
intergenerational trauma have on Aboriginal and Torres Strait Islander
peoples’ health
Providing medical
care
History
Takes a history of the presenting complaint with an appropriate review of
systems, using a biopsychosocial model
Identifies the ideas, concerns and expectations of the patient and describes
strategies to manage unrealistic patient or carer expectations
Recognises the impact sociocultural factors have on presentations,
compliance and patient engagement
Conducts an appropriate and focused examination with consent
Physical Examination
Investigations
Identifies patients in whom investigations are required to make a diagnosis or
create a management plan, outlining the factors to consider when choosing the
most appropriate investigation
Effectively communicates results to the patient
Identifies and manages the acutely unwell patient
Diagnosis
Synthesises clinical information to create an appropriate list of differential
diagnoses; can discriminate between the possible differential diagnoses
relevant to the presenting complaint
Takes appropriate steps to manage serious illness; manages acute
emergencies: asthma, anaphylaxis, seizures, chest pain/AMI, shock,
poisoning, overdose, envenomation, haemorrhage
MCCC Registrar Handbook 2017 54

Management
(Including response
to medical
emergencies)
Identifies evidence-based guidelines and key factors to consider when
prescribing medication; can communicate evidence and medication
management plan to patients
Identifies which patients will benefit from procedures; can obtain informed
consent and determine which procedures can be safely done in general
practice and those that require referral
Appreciates the risk associated with managing patients with undifferentiated
illness
Understands the role of general practice in coordinating patient care to
minimize fragmentation; identifies the role of the multidisciplinary team in
patient care and makes timely, appropriate referrals
Is able to do: CPR, ECG, IM injections, suture lacerations
See also: Skills and Procedures
Procedural Skills
Cognitive Skills
Synthesises information and problem solves at level of simple complexity;
uses hypothetico-deductive method for problem solving
Demonstrates a willingness to learn and improve; is reflective and self-aware
Can adapt to different work and clinical situations
Describes conditions and health risks prevalent in Aboriginal and Torres Strait
Islander and other culturally diverse populations and barriers to delivering
care; identifies local resources that assist in addressing these communities’
needs
Addressing health
needs of Aboriginal
and Torres Strait
Islander, other
culturally diverse
groups and
disadvantaged
communities
Population Health &
the Context of
General Practice
Has a patient-centered approach; considers the psychosocial and cultural
determinants of health and recognises vulnerable groups in the community
Understands public health roles relevant to general practice and public health
risks addressed in general practice
Describes the MBS and PBS systems
Begins engaging with the community
Professional,
Intellectual & Ethical
Role
Describes differences in morbidity and mortality in Aboriginal and Torres
Strait Islander populations and the doctor’s role in promoting health equality
in all culturally diverse and disadvantaged populations
Behaves professionally at all times; respect, duty of care, boundaries,
confidentiality, safety and privacy principles are understood and practised
MCCC Registrar Handbook 2017 55

Is committed to general practice; understand the principles of self-care and
advocacy for patients
Is willing to learn and extend; identifies learning needs and takes
responsibility for learning, identifies and commits to quality improvement
strategies
Organisational, &
Legal Dimensions
Describes the role research plays in reducing health inequality in Aboriginal
and Torres Strait Islander populations and other culturally diverse
groups. Reflects on own assumptions, cultural beliefs and emotional
reactions in providing culturally safe care
Maintains appropriate medical records; identifying what information must be
recorded, principles of record storage and legalities of use of patient data
Understands legal requirements; reportable deaths, medico-legal report
writing, confidentiality and informed consent
May have difficulty with time management but is organised and has a good
work ethic
Practicing medicine
in the rural & remote
context
Provides care in the
hospital setting
Response to medical
emergencies
Identifies models of care and policies relevant to Aboriginal and Torres
Strait Islander health as well as other culturally diverse groups
Participates in the provision of care away from other medical services;
respects local community values; commits to the acquisition of knowledge
required to care for the local population
Participates in the admission of patients to hospital; applies relevant
protocols; communicates with healthcare personnel and provides appropriate
handovers
Arranges evacuation; communicates with receiving clinical personnel;
performs an initial assessment of the critically ill patient
Useful Links
1. Australian curriculum framework for junior doctors
2. RACGP Curriculum for Australian General Practice 2016: Core skills unit
3. RACGP Curriculum for Australian General Practice 2016: Aboriginal and Torres Strait Islander
Health Unit
4. ACRRM Primary Curriculum 4th Edition
2.2 General practice under supervision: GPT 2/PRRT2
Communication
Skills: doctor –
patient and doctorinter-professional
Consolidates and refines communication skills; engenders confidence and
trust, appropriately uses closed and open questions, shows sympathy and
empathy and interest in patients
Begins to manage more difficult patients; mental health problems, heart-sink
patients, patient complaints, breaking bad news, carer distress and end-of-life
decisions
Addresses barriers to patients implementing health promotion and prevention
strategies; motivates and assists patients and recognises opportunity for health
education
MCCC Registrar Handbook 2017 56

Providing medical
care
History
Identifies Aboriginal and Torres Strait Islander patients as well as those
from other culturally diverse groups and addresses barriers to care and
communication; communicates in a culturally safe manner; optimizes patient
empowerment
Elicits a good history; incorporates the biopsychosocial approach and patient
preferences where possible; appreciates the impact diagnoses have on the
patient’s family and context
Elicits the patient agenda (ICE) and reconciles this with the doctor agenda;
creates a mutually agreed problem list
Examination
Conducts an appropriate and focused examination with consent and
demonstrates correct technique and use of clinical tools
Investigations
Judiciously orders investigations and is aware of public health costs; describes
the risks and benefits of investigations
Develops recall and reminder strategies for handling results
Diagnosis
Develops a diagnosis and executes a management plan for acute serious
illness and trauma
Refines diagnostic powers; fewer diagnostic dilemmas, differential diagnoses
are risk stratified, differential list is better prioritized and defended
Effectively communicates with and counsels patients about management
options including use of safety net
Management
(Including response
to medical
emergencies)
Uses unbiased and appropriate patient and guideline resources when
prescribing, managing and referring for procedures; discussed side effects and
risks with patients
Understand principles of restricted medications and off-label prescribing,
manages medication misuse and withdrawal; has a framework for managing
compliance issues
Manages diagnostic uncertainty and undifferentiated illness with greater
skill; appreciates mental health conditions that confound presentations of
undifferentiated illness
Effectively communicates with health professionals, provides hand-overs;
implements strategies to reduce fragmentation of care
Able to do: vaccinations, blood glucose testing, cervical cytology, simple
dressings
Procedural Skills
Optional skills may include: proctoscopy, cryotherapy, curettage and shave
excision, punch biopsy, excision of simple skin lesions, cautery, incision and
drainage of abscess, drainage of joint effusion, joint injections, insertion of
hormonal implants, spirometry
See also: Skills and Procedures
MCCC Registrar Handbook 2017 57

Synthesises information and problem solves at level of moderate complexity;
uses pattern matching when problem solving
Cognitive Skills
Conducts a structured consultation and competently manages common
presentations
Manages diagnostic uncertainty related to cultural beliefs and uses strategies
& resources to enhance health outcomes.
Addressing health
needs of Aboriginal
and Torres Strait
Islander, other
culturally diverse
groups and
disadvantaged
communities
Population Health &
the Context of
General Practice
Begins to apply principles of partnership, community ownership,
consultation, capacity building, reciprocity and respect to health care delivery
to disadvantaged groups
Implements individual and national population based screening activities in
the consultation; motivates patients to participate
Advocates for vulnerable groups and appropriately accesses government
funded programs
Understands requirements for public health notification; can manage public
health risks and communicable disease outbreaks
Professional,
Intellectual & Ethical
Role
Uses evidence and healthcare delivery strategies (including MBS programs,
health promotion & community education) to reduce health inequality in
Aboriginal and Torres Strait Islander populations and other
disadvantaged groups
Behaves professionally at all times; respect, duty of care, boundaries,
confidentiality, safety and privacy principles are understood, practiced and
evaluated
Is committed to general practice; practices the principles of self-care and
advocacy for patients and coordinates patient care
Is willing to learn and extend; identifies learning needs and takes responsibility
for learning, identifies and commits to quality improvement strategies
including reporting and managing critical incidents; seeks to learn alongside
others
Understands mandatory reporting and has a framework for supporting a
colleague in difficulty
Organisational &
Legal Dimensions
Describes ethical approaches to research in Aboriginal and Torres Strait
Islander health and other culturally diverse groups
Effectively uses practice systems (including IT systems) for patient care;
reviews, recalls, handling of abnormal test results, managing failures to attend
Identifies and manages occasions when duty of care clashes with
confidentiality requirements; understands when MDO advice is required
Demonstrates an understanding of patient competency and shared decision
making; appreciate legalities of caring for patients who cannot give consent
MCCC Registrar Handbook 2017 58

Understands certification; WorkCover, Centrelink, care plans, billing rules,
notification requirements, involuntary admission legislation
Practicing medicine
in the rural & remote
context
Provides care in the
hospital setting
Response to medical
emergencies
Understands Aboriginal community controlled health services; uses
government programs and policies to enhance care delivery to Aboriginal
and Torres Strait Islander peoples
Provides effective clinical care when distant from medical services;
demonstrates resourcefulness when working in isolation; arranges
appropriate referral to distant services, is becoming confident in the use of
information and communication technology in provision of care
Develops and implements management plans for hospitalised patients
including the management of fluids and blood products; monitors clinical
progress; manages the deteriorating patient; arranges transfer to other facilities;
engages in discharge planning
Provides definitive emergency care, resuscitation and performs procedures
across all patient ages
Useful Links
1. Australian curriculum framework for junior doctors
2. RACGP Curriculum for Australian General Practice 2016: Core skills unit
3. RACGP Curriculum for Australian General Practice 2016: Aboriginal and Torres Strait Islander
Health Unit
4. ACRRM Primary Curriculum 4th Edition
2.3 At time of fellowship: GPT3-GPT4/ PRRT3-4
Communication
Skills: doctor –
patient and doctorinter-professional
Communication style is respectful, clear and adaptive; adjusts communication
to suit age, gender, cultural background, emotional state and physical state of
the patient
Involves the patient in decision-making; provides appropriate explanations,
discusses diagnostic and management possibilities, negotiates courses of
action, encourages feedback and input from patients and carers.
Coordinates care that is continuous and meets the needs of patients in their
context; offers advice on health options and communicates with family
members and practitioners involved in the patient’s care
Uses a patient-centered, whole person approach that builds mutual
confidence; understands the impact a patient’s culture, history, gender and
background impacts on their experience of health; seeks to promote health and
wellbeing
Providing medical
care
History
Aboriginal and Torres Strait Islander patients are identified. Culturally safe
communication is practiced with all culturally diverse groups; historical and
cultural influences are appreciated and incorporated in to the consultation.
Uses interpreters, key community contacts and networks as appropriate
Takes a comprehensive, structured and biopsychosocial history from the
MCCC Registrar Handbook 2017 59

patient and documents this clearly; interprets symptoms in their socio-cultural
and medical context
Examination
Investigations
Diagnosis
Management
(Including response
to medical
emergencies)
Procedural Skills
Cognitive Skills
Performs a respectful, appropriate and competently executed examination,
with consent
Rational investigations are ordered and explained; a structured framework for
following results up is in place
Differential diagnoses are rational and defensible; uncertainty and
undifferentiated illness is managed
Manages a wide variety of patients and problems comprehensively and in a
cost-effective and evidence-based manner; works within limits of own
expertise and coordinates the involvement of appropriate health practitioners
May be developing an interest and proficiency in a procedural field
Synthesises information and problem solves at level of increased complexity;
draws on various resources and skills in doing so. Is critical and
discriminating
Has honed reflective abilities and insight
The conduct of the consultation is appropriate to the need of the Aboriginal
and Torres Strait Islander person and their sociocultural context.
Addressing health
needs of Aboriginal
and Torres Strait
Islander, other
culturally diverse
groups and
disadvantaged
communities
Population Health &
the Context of
General Practice
Works with culturally diverse and disadvantaged groups to address
barriers in access to health services and improve the determinants of health
Promotes holistic health and preventative care to individuals and to groups,
appreciating the individual, contextual and epidemiological determinants of
health and disease
Advocates for patients, identifies and manages barriers to care
Practices in a cost-conscious manner; has a deeper understanding of the
Australian healthcare system
Professional,
Intellectual & Ethical
Role
Promotes screening and management decisions based on an understanding of
Aboriginal and Torres Strait Islander person health needs as well as those
of other culturally diverse and disadvantaged groups
Practices professionally and adheres to the code of professional conduct;
justice, beneficence, non-maleficence, autonomy and confidentiality
Engages in self care and maintains a balance between involvement and
applying appropriate boundaries
Is committed to lifelong learning, actively and independently seeking out
educational opportunities; engages in the education of others
Takes a leadership role in arenas outside of patient care (organisations,
community groups, practice meetings)
MCCC Registrar Handbook 2017 60

Organisational &
Legal Dimensions
Identifies opportunities for research and teaching in Aboriginal and Torres
Strait Islander health and other disadvantaged groups
Manages the systems of General Practice: (data management, documentation,
certificates, insurance matters, billing, care plans and practice management)
Understands and works within statutory and regulatory requirements;
manages medico-legal responsibilities, recalls and reminders and
confidentiality
Manages time effectively
Practicing medicine
in the rural & remote
context
Provides care in the
hospital setting
Response to medical
emergencies
Is aware of strategies that promote culturally safe practices; uses policies and
initiatives to promote equality in care of all culturally diverse groups
Practices independently in isolation; provides supervision to healthcare
personnel; uses information and communication technology to manage patients
and communicate with colleagues
Provides supervision to healthcare personnel; manages adverse events;
participates in quality improvement initiatives; contributes to the medical
expertise of the hospital team
Leads an inter-professional team in delivering emergency care; participates in
disaster planning; stabilizes critically ill patients, providing both primary
and secondary care; performs required emergency procedures
Useful links:
1. Competency profile of the Australian general practitioner at the point of Fellowship
2. RACGP Curriculum for Australian General Practice 2016: Aboriginal and Torres Strait Islander
Health Unit
3. ACRRM Primary Curriculum 4th Edition
MCCC Registrar Handbook 2017 61