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Supervision seed planted early

GP supervisor Lisa Fraser says registrars should be inspired to build mentoring skills as a stepping stone to becoming supervisors.

Lisa Fraser realised early in her medical training that teaching and mentorship were implicit to the sustainability and enjoyment of the profession. And, so began her own journey into life-long learning and teaching, which Lisa says should go hand-in-hand with a GP career.

“I had great mentor experiences in my early training as a medical student,” Lisa, 39, said.

“It was very clear to me from those experiences that teaching was what made medicine sustainable, enjoyable and a great profession.

“After six years in the hospital and three years on the physician training program, I began to appreciate my interest in general practice.

“My initial career path was towards geriatrics, however I started to feel more confident about the diversity and complexity of general practice with more experience and the life stage of motherhood.

She fellowed with RACGP in 2016 and swiftly took on GP supervision at medium-sized practice Priority Health Medical Centre in outer Brisbane, where she works part-time.

While only newly fellowed, Lisa said the positive influence of her early mentors had set in motion the building blocks to becoming a GP supervisor so early in her career.

“There were opportunities to grow skills in teaching and supervision everywhere along the way,” Lisa said.

“At Priority Health, we have many different levels of training doctors in our practice, so it was very organic for me to start supervising registrars and medical students as we function with a high level of interaction.”

Lisa had previously built her experience and passion for training and mentorship through a variety of roles, including committee and medical educator positions with GPRA, GPME and GPTQ.

She believes early engagement with students on a pathway to general practice, is important to prepare them to consider – and be ready – to become supervisors early in their career: in turn, helping to “normalise” training and supervision as a culture of general practice.

“Supervision is part of all of our professional commitment to medicine, albeit is more challenging in the GP environment compared to the hospital,” Lisa said.

“We need to normalise training to improve quality, more young supervisors, more training practices, more patient acceptance and skills from administration staff.”

Lisa said “only about 30 per cent of practices are training practices,” and attributed this low percentage to “a product of time, and environment”.

She is passionate about encouraging a growing participation rate and would like to see 40 per cent of training practices in metropolitan areas by 2025.

“The seed for supervision needs to start in registrar years,” Lisa said.

“Historically there have been barriers to registrars and new fellows advancing their careers in medical education and supervision due to belief that juniority meant lack of competence.

“We are now progressing towards a competency-based model, with the recent change in RACGP criteria, which is more in line with current evidence.

“Some junior doctors have acquired extensive training in medical education and supervision before fellowship and some naturally have greater competencies in this area, so waiting five years before getting more involved in this field only serves to disengage fellows with the teaching culture and cause losses to the natural progression.”

Lisa believes junior supervisors and new fellows need to be represented in supervisor groups like RTOs and GPSA to reflect the profession’s commitment to diversity and inclusion.

She said new fellows had unique needs and characteristics which value-added to the supervision training group, such as their recent training and examination experience; cultural and generational diversity; and close connection to registrar perspective on studying and training towards fellowship at a young stage of life, often juggling children and parenting.

On the flipside, starting the supervision journey early, also added a unique value for the new fellow, Lisa said. “Starting your supervision journey young adds something different to your journey as a new fellow.”

Lisa said people should not be afraid to combine the steep learning curves of being a new fellow and GP supervisor in supportive practices with positive training cultures.

“It works well to do both in tandem. Having both journeys together marries well, and enhances your learning.”