Chair’s Report May 2022

Nicole Higgins
GPSA Chair, Dr Nicole Higgins

Change as a door to opportunity….

Sometimes we get so caught up in what is changing we fail to pause, zoom out and put change into perspective. 

The role of GP Supervision largely happens independently of the administration of GP training. 

Despite multiple changes to RTOs, RTO footprints, the demise of GPET and now the transition of training to the colleges, the piece that doesn’t ever change is the critical role GP supervisors play in the process. Registrars and the community can feel heartened that their day to day will mostly remain unchanged. Training practices and  supervisors are the one constant and  90% of GP training  occurs within training practices under the expert supervision of accredited GP supervisors. 

Having been through a transition in 2015 I understand the hurt and loss.  We  appreciate that for many staff within the RTOs, GP training has been their life; for some as long as 20+ years. So there is considerable grief and in some cases anger, even contempt for the change that directly affects and  impacts them. To all RTO staff, leadership and boards struggling with what the transition represents, we see you, we hear you and we feel your pain. GP Supervisors have forged strong alliances with all of you across those 20+ years and we hope to see many of you continue working with the colleges in 2023 and beyond.

All players within the sector are here to ensure transition goes smoothly – including GPSA.

"To all RTO staff, leadership and boards struggling with what the transition represents, we see you, we hear you and we feel your pain."

Dr Nicole Higgins

No organisation or individual is immune to change. GPSA will enter a phase of renewal over the next six months as the board seeks to bring fresh skills and eyes to its governance through the call for expressions of interest in joining the board that was put out last month. The EOI closes on the 20th of May.  We have had a wonderful response from our community and we will continue that process and keep you up to date as new directors are appointed.

There is also a new opportunity emerging within the GPSA leadership. Glen Wallace, our CEO of over seven years, has accepted a leadership position within the RACGP Profession Led Training team. 

Glen took on the position in 2015 – two years after GPSA was formally funded by the Department of Health. At that stage the organisation barely had any educational resources developed to support the membership, had really no research portfolio to speak of and about a third of today’s membership. 

Glen has led the organization and an impressive team to what has now evolved into two research journal publications annually and the production and maintenance of over 350 educational resources which continues to grow annually and importantly be consumed and used by stakeholders. 

Glen’s approach has always been pragmatic and oriented to what matters most to GP supervisors. We congratulate Glen on his new position within the college and thank him for his service to the GP supervisor community. His vision, collegiality and pragmatism will be an asset to the RACGP and to the profession as we head into the business end of this transition.

We are now seeking expressions of interest (EOIs) from the General Practice and GP Training community to fill the position of CEO at GPSA. To this end we have placed the position description online. Prospective candidates are encouraged to initially make themselves known to the GPSA board by emailing a CV with their expression of interest to governance@gpsa.org.au.

On a personal level, I have loved working with you Glen and how our ‘brains go ping’ to develop ideas and solutions. You will be missed and I wish you all the best in your new role.

Yours in training,

Dr Nicole Higgins
GPSA Chair

Supervisor Profile - Dr Brad Murphy

Brad Murphy
Pictured: Dr Brad Murphy OAM
Dr Brad Murphy OAM has had an extensive career as a GP supervisor and work within Aboriginal and Torres Strait Islander health and veterans’s health in particular. He is a proud Kamilaroi man who has also served in the Navy, and is passionate about developing more First Nations GPs, and he has played a vital role in mentoring new First Nations GPs. In 2022, he received an OAM and is running for the presidency of the RACGP.
What rewards do you feel you have gained from GP Supervision ?

It’s really lovely to give people coming from the hospital system and overseas an introduction to what Medicare is all about and to show them what you can do for different subsets of the population, like Aboriginal and Torres Strait Islander patients and Veterans that that we specialise in, as well as other groups. Helping them to know what’s available for your community. Also, to show them some of the challenges in General Practice about dealing with the hospital system, and registrars bring some of their skills and contacts within the public system to help bridge some of those gaps. For me it’s acknowledging that it’s a two-way street. It keeps us as GPs and GP supervisors on our toes, because when you engage in training you keep your own skills up, which flows on to the other staff who buy into the team-based approach around training. It’s really important that people going through their training understand the challenges of people answering the phone and people who are demanding and need help straight away. I have been involved as a supervisor for over 20 years, including work with ACRRM working with registrars who were most in difficulty, which was a great learning pathway for myself. I’ve really taken a lot from this journey and if you give people wonderful experiences, down the track you hear of them in other places in training programs, rural and remote medicine and some returning to my practices which is really great. If you can inspire people to consider general practice, or just as importantly to have a really good appreciation of general practice, so that if they happen to be the emergency position in Brisbane, who takes your call it two o’clock in the morning when you’re in crisis in a rural center, that’s gold. I think to be involved in that process is really exciting.

 

For me it’s acknowledging that it’s a two-way street. It keeps us as GPs and GP supervisors on our toes, because when you engage in training you keep your own skills up, which flows on to the other staff who buy into the team-based approach around training.

What type of things do you feel you have learnt from GP registrars?

From my point of view culturally, I mean from an indigenous point of view, you think you’re culturally aware and from a veteran and first nations point of view, I I’d like to think I am, but we all have better and worse days. Certainly, dealing with a lot of our overseas trained graduates, you get a huge appreciation of a whole range of communication strategies and cultural perspectives that come into play about how they communicate with patients. If nothing else, because of the multicultural perspective of the training that I’ve been involved in over the last 20 years, I’ve certainly got a huge appreciation of the various socioeconomic and cultural perspectives that come into play. One of the things that I’m really proud about in what we do with first nations health is that if you do first nations health really well, you can’t turn those skills off. So, when you’re dealing with mainstream populations, then everyone benefits from it. I think it’s very much the same if you have a multicultural perspective. If I was to say one thing, it would be communication strategies, picking up on body language of patients. It’s not just about Aboriginal people that don’t make eye contact. Lots of people don’t make eye contact, and it can often mean different things, but it’s about picking up on awkwardness or people not wanting to be disrespectful by asking. Being comfortable enough to ask them and make sure that the message is getting across. You can think you’ve nailed it and you haven’t even touched the mark. So I think that that would be the really big lesson for me.

What are the challenges of GP supervision?

Mostly if there’s difficult registrar or difficult student. The good ones are easy; not easy as in, you don’t need to do anything, but because they’re passionate, they’re enthusiastic, they’re engaging. You don’t have to go looking for them. The ones that are having challenges, they’re the ones that are hiding in a busy day. It can be difficult to know that there’s a problem. Because when you’re supervising people and it’s not exactly one on one, they can be having problems behind closed doors. You are very much relying upon communication from the patient to let you know that there’s a problem. It’s being astute enough to monitor it sufficiently, to give people respect and allow them to learn, but at the same time, not letting things get out of control. I think that’s a real skill to know. The intern that I’ve got at the moment has been extraordinary from day one, amazing. She’s been doing surgery, and is a really valuable part of the team. And while they’re not here permanently, she has behaved as if she is. Because of that, it’s allowed us more time to spend together to actually do learning. Whereas a previous student was very quiet and very knowledgeable, but you wouldn’t know it. It was a real challenge because in the 12 weeks that they were here, I don’t think I truly connected with them. We tried multiple strategies as a team and talked to external parties and supervisors that they’d had in other placements to try and work through what the issues were. By the end of that 12 weeks, I felt really drained. To this day, I don’t feel that I necessarily was able to get the best out of the opportunity for them. I think that’s the real challenge for me, where it’s difficult and not straight forward to make sure you are using a learning process that gives them the best opportunity. There are really valuable opportunities in recognizing problems and exploring the difficult nature of how you actually deal with that, and not being too proud to ask for help.

What do you focus on when supervising registrars?

It’s trying to recognise where the shortfall is. Is it a cultural perspective? Is it an interpersonal communication thing? I mean, people with similar cultures still have trouble communicating. The other thing is identifying any skills deficit that happens to be there, which is a problem in general practice. Their skillset is huge compared to our colleagues that can be specialists in a narrow field. You’ve got to, have some degree of trust in your trainee that they’re hit the mark, and I think that extends to supervisors as well. You need to have some appreciation of what’s happening behind closed doors to make sure that everyone’s safe and that good patient care outcomes are being achieved, and a learning opportunity is achieved as well. I think that can be really difficult to do. It means the whole team being onto it. I don’t think it’s the responsibility of the supervisor. I think it’s the whole team, because I’m relying upon the feedback from nursing staff and reception staff to say, “Hey, there’s a problem here.” It’s a bit like dealing with mothers when they bring their children in. We may not agree on what the problem is, but a worried mother is always right. You know, they know their children. So you have to explore that. If the reception staff say to me, there’s a problem with a registrar, then there’s a problem, even though we may not agree on what the problem is, something needs to be addressed. It’s a really complex arrangement and you add that to your day. It’s important to try and allocate some training time, but sometimes the training doesn’t fit neatly into a 15-minute slot, it’s training on the run. Opportunities to debrief and get to know people are also important. We’ve got quite a social, aspect to how we operate the practice here, which gives us time to engage with families and stuff as well, which hopefully allows people to feel more comfortable and have a different sort of engagement, but you know, it doesn’t always work. It’s a great model that’s worked for us, but it hasn’t worked all the time.

How could more Aboriginal and Torres Strait Islander GPs be supported?

When she was health minister some years ago, Kay Patterson said that she thought it was inappropriate that first nations doctors qualify and don’t go back to their communities. But there are complexities of practicing in your own community. Like telling one of your Aboriginal elders, that they can’t have something like narcotics, or other stuff even and the need to show respect. So sometimes it’s better to go to another community down the road in another place where you can still be from a first nation’s background, but not have those community connections at the same level. But the other thing is, why does a first nations doctor not have the entitlement of a career progression equal to their colleagues? If you happen to be a neurosurgeon in New York, what an amazing message that sends back to your community about the opportunities that lay ahead for you, if you want to commit yourself.

So I think that, there is a level of ignorance, and sometimes amongst ourselves, and you’ve gotta have a lot of insight into this. The journey begins very early, it’s basically at childbirth. It’s about giving people a really good health experience. So giving a young mother a really good positive experience so that she has a healthy baby that gets born with every opportunity in a lifetime. That the baby then gets good schooling and opportunities and mentors and Australian indigenous doctors. AIDA do a lot of stuff when they have board meetings in a community, and they’ll actually engage with the community while they’re there, obviously with the aim of growing doctors, but actually it’s about inspiring the kids at school to finish school and do whatever they want. If they happen to go into the health field, that’s awesome. But it’s really about giving the opportunity to actually finish school. I think those sorts of things are really important. When people are going through the health training, it’s about allowing them to be a student. I know that when I went through, I was token a blackfella in my tutorial group. So anything that came through that had a first nations flavour to it, I became the expert. But I was paying my money. I was there as a student to learn. It assumes that I’ve got all the answers and I don’t. It is also ignorant to the fact that some of these things are talking about my family and can be very painful. When you’re talking about some of these journeys through diabetes and amputations, you know that could be my grandmother. There’s a level of ignorance about that journey that is done by people absolutely meaning well, but we get better at this as we go on. James Cook was really good at it, but nonetheless, I found myself in that scenario. A lot of first nations people often don’t necessarily get the straightforward road through. So they don’t necessarily finish high school and go into medicine. They’ll, they’ll often be an Aboriginal Health Worker, do nursing and then go into medicine.

I still remember one of my colleagues that I visited when I, went over to Broome and we went out to this remote community that he’d worked in as a nurse. Then he’d finished his medical school and he was on the AIDA board. As we drove into the community and the houses started to populate around you, you could hear these voices saying Aaron! Aaron! and the joy of the town about Aaron coming back. I just think that they’re the memories that will always hold true to me. A really good doctor going back into some communities doesn’t always inspire that sort of response. And the trick is how do you? Why can’t you? Some doctors absolutely do. If I was to say, well, what, what’s the journey look like? It’s about making sure that a baby is born healthy, free of foetal alcohol syndrome and those sorts of things, but given the best possible start to life into a family that appreciate healthcare as an opportunity that’s extended to them. Good schooling, good outcomes.

Central Queensland university are running a program with the University of Queensland called the regional pathway to medicine. It’s a three year biomedical science degree, and three first nations people started two weeks ago. The first nations people on the course are guaranteed if they pass to transition from the end of their course straight into the University of Queensland medicine degree. I’m their mentor for that seven year journey, plus we’ll have a lifetime journey of hopefully becoming friendly as I help support them in their career. If they happen to end up as a neurosurgeon in New York, I’ll have a pretty amazing phone friend. It’s about networks, absolutely. About mentoring and networks. That’s the complex nature of it, and if we do that across the spectrum, you don’t turn those opportunities off for anyone. We take that as a bit of a fundamental right in mainstream health.

Does being Aboriginal influence the way you supervise?

Yes, on a couple levels because I haven’t had that typical pathway into medicine. I left school in year 10 because someone said to me, it’s not all that important anymore, but I became an associate professor at Australia’s private university. I’m now a professor with a year 10 education, without a master’s degree. It’s pretty much about being in the right place at the right time when people like Bond needed desperately to have some curriculum development in that area, otherwise they wouldn’t get their registration. It’s about opportunities, but hard fought ones. I mean, no-one’s given it to me on a silver platter, I think it’s certainly the road less travelled. Professor Peter O’Mara would tell you a similar story, starting out he also left school in year 10 and became a mechanic in the mining industry and ultimately he’s now the professor of medicine at the University of Newcastle.
When I started, there were 30 Aboriginal doctors and 70 medical students, and now there’s several hundred, but the disproportion is still quite large and there’s an expectation for you to go onto committees. Everyone wants the token blackfella, and it often happens in general practice. But a lot of the committees that I’m on with say Queensland health, the Queensland health people are all remunerated, but the expectation is I’ll do it for nothing. I’m happy to do it for nothing because that’s about advancing the healthcare of my mob, but my wife is not indigenous and she is entitled to superannuation and the rewards for a life’s hard work. So every time I go and do that, that actually affects other people’s bottom lines as well. I think the expectation that we’ll keep giving for no remuneration is wrong, when everyone else around is being remunerated. No-one wants to talk about the money and it’s not about the money for me, but I’ve still got to pay to keep the business structure running here.

One of the wonderful things in our practice is that the place is full of Aboriginal artwork. I can tell you the stories behind the artists and, how it came to be here, much of it is to do with, sometimes local guys selling it out of their boot, because they were desperate for money. Others it’s because I sat in the central Australian desert with the artist and watched them paint and talked to them and shared their story. But my mainstream patients that come here know that they’ve got an Aboriginal doctor, that they’re being treated by a black fella, but they know that there’s a cultural respect that happens here that I’ve had to work hard to get and they have that trust in me. So it’s not second rate medicine, they’re coming here because it’s top notch, or I certainly think so.

Because you have an opportunity to be involved in a lot of the committees and processes, you also bring that back to the coal face. A lot of the problems that we might have in general practice today around the medical provider number or the pharmacy trial that’s in the newspapers, the fact that you have firsthand knowledge and participation around some of those issues is really valuable. I’m conscious too that sometimes when you go off and advocate for people in the profession that I’m off advocating and often not being remunerated so that I can actually help the bottom line of the guy down the road, who’s still churning through the patients making a profit. I don’t care less about that, but the concept’s not lost on me. One of the things that I love most about medicine is doing that medico political stuff, which is obviously why I put my hand up to run for the presidency of the RACGP college. Certainly to be Australia’s first ever indigenous president of any medical college would be a great message to send back to the community, to say you can achieve this. So I think there’s a level of pride and you learn to be humble. But at the same time, you still have to put yourself forward in order to get where you want to go. I think that reflects upon your role as a GP, the way that you practice medicine and the way that you supervise and teach as well.

What are some of the key considerations that you think are important to tackle with first nations health?

I think it’s about being appreciative. It’s about taking every patient that walks through your door on face value and not expecting or pigeonholing them and if you do that for every patient, you’ll always be on a winner. I think that, you know, everyone’s an individual treating them as such, treating them as a whole person. And I think that’s the thing about the pharmacy trial is that it’s really difficult to piecemeal this. It’s all well and good to give them their Diaformin for their diabetes, but are you addressing the smoking issues, the obesity issues, the complexities in the home, all of those, key issues around, home hygiene and overcrowding and all those sorts of things that are drummed into us day in, day out as we go through our training. So I think those things are really important and so that when someone comes to see you, there’s an opportunity to upsell. But for us, it’s about looking at the bigger picture, not about necessarily selling them probiotics with their antibiotics. So, you know, I think for me, that’s it, it’s about the patient relationship. It’s about understanding people’s individual journeys, because not every first nations person has had the same journey socially or financially and all those sorts of things. It’s about seeing people on an individual level, treating them as such and going on a journey with them.

For me Aboriginal health is about a journey of complexity of care, treating people who are healthy and try and keep them that way. I try and avoid the emergency management in that I don’t want to just do coughs, colds and saw holes. You have a relationship with a patient who comes in occasionally for immediacy type issues, but in the main it’s about coming to see you to tell you that they’re well and to do their bloods and talk about all those things that keep them healthy. That to me is the model that I use for all my practice. All of my patients sign up for that. Even down the track, when they say, “oh, no, we don’t want to come in, there’s nothing wrong with us,” I say “Well, that’s what you signed up for. Maybe you need to consider another practice.” It’s just one model, but that’s fed by that first nations thing. It’s about taking people on a journey of healthcare and keeping them healthy and doing the other stuff that punctuates along the way, rather than making that your mainstream contact.

It's about understanding people's individual journeys, because not every first nations person has had the same journey socially or financially and all those sorts of things. It's about seeing people on an individual level, treating them as such and going on a journey with them.

What rewards have you gained from your work in veterans affairs?

I think from my perspective, because I did six years in the Navy starting as a 15 year old, I have a shared experience with veterans. Our experiences are very unique, but we’ve all done our junior level training, the NBCD training where we go through the gas chamber and they whip the mask off at the end, and you cough and spew as you come out. So when veterans come to see me, we start on a level of shared experience and I think that’s really amazing. Not everyone necessarily gets that. We’ve got five doctors here. Two of us are Navy. I think the thing is understanding the veteran journey and you don’t have to have lived it. It’s interesting because most of the time the causes of problems are not what you think. A lot of these guys have taken people’s lives, and while no-one tells me they loved that experience, problem causes are most often around management decisions or Intel that they gave that wasn’t followed. So therefore, troops went a different way and they were involved in a bridge that was blown up and lives lost, or they had to pull out of a community early and the insurgents came in and raped and pillaged the community and other things that are outside their control. It’s actually quite interesting to talk to these guys about what their triggers are. Everyone’s experience is their own, and you go on a journey with them and you allow them time to tell their story. It took 27 years to get one fellow to actually open up to me, and all I asked is what his triggers and when do I need to keep you on my radar during the year? When are the anniversary dates so that I can just make sure I’ve got my eye on you. He then opened up and told me the lot, which wasn’t my question. I said to him, it’s not important, I know what the issues are, I just need to know when I need to keep an eye on you. Over that period of time, you get to develop that relationship.

The other thing for veterans affairs is understanding that they are a special group of people who have opportunities in healthcare that mainstream don’t have. There’s almost nothing you can’t get for them, if you can mount an appropriate evidence based response. You can get them things like sunscreen and things that aren’t available on PBS for the mainstream, you can actually get approval for on RPPs. Things like for example new diabetic injection, you can actually get for veterans for weight loss if they’ve got an accepted condition that losing weight would be beneficial for. There’s a process you can go through. We’re trying to get this information into the medical schools and across the curriculum, but the take message is that if you ring up this number, you can often find different opportunities. Knowing that their family are entitled to things like open arms counselling as well. It’s all a little bit different. Having an understanding and knowing where to phone, you can usually get some good guidance. Just generally being aware that veterans might have other opportunities that you might not get for mainstream patients, and Aboriginal veterans get a different level of care as well.

How has GPSA Supported you?

There’s been a lot of value for me meeting and talking to the staff at conferences, in those days when we were allowed to travel and have conferences. I’ve always found the team to be really good and very approachable. That was always evident. Certainly through the RTOs and other stakeholders, GPSA have always had a great presence there in the training that we’ve received as supervisors coming along and talking to us about issues relating to business management even and remuneration issues, and the importance of not necessarily negotiating with your registrar because it makes the landscape more complicated. I’ve always found that to be really useful, as well as the webinars. Even knowing that the organisation is there is invaluable, particularly if you’ve got a problem. It’s one thing to not be embarrassed to ask a friend, to extend that to the public hospital system, and interns and training providers, if you’re not sure and don’t necessarily have that relationship with the training provider and don’t want to discuss it with them, knowing that GPSA is there is really invaluable to know that you can get an independent hearing from someone with a wealth of experience on this issue. It might be my first time, but it might be a common problem with registrar training that they can help us with, so I think that’s really amazing.

What would you say to others considering becoming a GP supervisor?

Training is probably not my absolute desire or my greatest skill. We all have things that get us out of bed in the morning. But it’s certainly been an experience that’s given me a lot of joy, and to watch other people go through their careers and to grow and often have contact around the place is really a lovely experience. It valued adds to the surgery, notwithstanding sometimes it’s a bit problematic. In the main its been a really positive experience and I would encourage people to embrace it, not be afraid to ask for help, and go a journey with their colleagues. The mentors that I’ve got through the college that I’ve met, all wear similar hats. It’s been really amazing, that fact that I’ve got all these phone a friends if I’ve got a problem. I don’t always need to use it, but when I see these people it’s a really great experience it’s like catching up with long lost family, so it’s a great feeling of camaraderie in the group. I would absolutely encourage people to get involved, and ideally to get a few people within the practice involved so that you’re not doing it on your own. I think it’s a wealth of knowledge and experience and helps to optimise your own skillset and keep it current. Particularly in the digital age where a lot more resources are at your fingertips, it’s less daunting. So give it a go and don’t be afraid to reach out to GPSA and your training provider for help if you need it.

Recognition Reward Program

GPSA Reward and Recognition program

The GPSA reward and recognition program recognises the hard work and dedication of GP supervisors. If you are are a GP supervisor with over 10 years of supervising experience, we would like to recognise your dedication to nurturing the next generation of family practitioners. To nominate, you must be accredited by the Royal Australian College of General Practitioners (RACGP) and/or the Australian College of Rural and Remote Medicine (ACRRM) to train GP registrars engaged within the Australian General Practice Training program.

Nominated GP supervisors will receive:

  • Recognition of Service Award
  • ‘Training Practice is a Quality Practice’ Poster
  • Media release advising local MPs and your local media of your service to the community

To nominate a GP supervisor or yourself please click the button below

Chair’s Report March 2022

Nicole Higgins
GPSA Chair, Dr Nicole Higgins

Supervisors – As servant leaders we continue to get on with the job

Supervisors understand servant leadership better than most – after all, almost everything we do serves and advances a greater purpose – patient wellbeing, community health, public spending, and importantly renewing our workforce and replacing ourselves.

There are very few GPs who are ‘Just a GP’. Many of us sit on boards, faculties, run businesses and while change happens around us, we keep the ship steady and on course. That is because supervisors understand Done is better than perfect: perfection is achieved through the courage to learn whilst doing and improving with feedback. Such is the nature of supervision and registrar training.

With 10 months until transition of training back to the colleges, GPSA is feeding back to the colleges and government what we need, what we expect and how support for supervisors, training practices and practice managers can be improved. Time is of the essence.

We need to ensure that general practice as a profession is equitable, sustainable, consistent and flexible enough to attract a new generation of doctors. General Practice is not a self-sustaining renewable resource. Registrars, Supervisors and the General Practice Profession as a matter of sustainability need to be recompensed adequately and competitively with other medical disciplines. GPSA strongly supports the progression of parental leave for registrars and is involved in discussions on portable entitlements and remuneration.

"supervisors understand Done is better than perfect: perfection is achieved through the courage to learn whist doing and improving with feedback. Such is the nature of supervision and registrar training."

Dr Nicole Higgins

All doctors-in-training must be supervised

Patients deserve to be treated by a doctor-in-training who is supervised. No matter what program – AGPT, Fellowship Support Program (PEP), MDRAP or RJTIF, our learners deserve an equitable system that supervises and supports them through their learning journey.

Adequate resourcing

The nationally consistent payment of supervisors and training practices needs to be applied consistently across all GP training programs including John Flynn, RJTIF, MDRAP, PEP, FSP, IP, and AGPT (including RVTS supervisors and training practices). Acronyms are confusing aren’t they? Shows you how complex this has become!

Hard to fill priority locations should be supported with bespoke registrar and practice supports to fill them as a priority as RTOs have done. 

National, Plain Language Practice Agreements

We currently have 9 RTOs each with their own practice agreements ranging from 5 to almost 30 pages in length. Some in plain language and others thorough in their legal language. Practices want to be able to quickly and plainly see what they agreeing to in taking on registrars – now and into the future.  

Adequate Supervisor CPD

Supervisor CPD needs to be funded and flexible. Face to face peer networking and support combined with online training with training pitched to the right level of experience. Just like a new registrar – new supervisors learning needs are very different.

Adequate Practice Manager CPD

Practice Managers are truly unsung heroes in the GP training space. They are most often the information gateway to supervisors, as well as the key enablers of so much of the GP training program. So much so you don’t notice their work until it is absent. This important group need to be catered for in the new GP training paradigm as they have been under the RTO training providers.

Adequate Supervisor Liaison Officers (SLO) representation and support

SLOs are an essential cog in GP training. They reflect the vast and specific needs of supervisors nationally and provide a local and contextualised view of GP training in the regions. SLOs need to be recruited, retained, resourced, and connected nationally as a peer support network promoting best practice. 

Our SLOs need to:

  • know who the supervisor cohort they are supporting, 
  • have support and resourcing to communicate Best Practice in their liaison with supervisors and training practices.
  • have support and resourcing to network with their national counterparts to advance Best Practice 

Adequate Practice Liaison Officers (PLO) to support local delivery

RTOs have evolved over time in their service delivery to practices. Those that rate highest among supervisors, practice managers have a highly effective practice liaison and support staff. This must be replicated by the colleges as they move forward.   

IT and communications systems developed for the end user

GP Supervisors and Practice Managers need to be placed as a priority in IT development and communications systems. This will require adequate user acceptance testing by Supervisors and Practice Managers to build best practice into the systems being developed now.

GPSA has approached the colleges and the department to be involved with their development of management systems and with the Health Services Australia payment system.

Continuous Improvement vs Quality Assurance

GPSA is excited to introduce the GP Clinical Learning Environment (GPCLE) Framework to supervisors and practices. This is a system that makes finding and doing anything to do with training a registrar simple and easy. I am a supervisor and a practice owner so anything that can easily support me to improve the training I deliver and support my practice manager is a big yes from me. 

The common denominator between high performing and low performing training environments is that both are accredited. There is no review of quality. Practices and Supervisors are best supported by a consistent orientation to best practice and continuous improvement. The GPCLE and resources must be integrated with accreditation and CPD in the future training program and adequately resourced.

GPSA is a small organisation with a big heart and a big impact.

Last month we held our strategic planning weekend and board review. It was wonderful to see the team face to face and to plan for an exciting next 4 years. GPSA and the board thanks Dr Collie Mullins who is stepping off the board. Collie has made a great contribution and she will be missed.

GPSA is about to put out an EOI for new board members.  We are an experienced board who gets stuff done. AS GPSA are committed to diversity, we encourage EOIs from:

  • early career junior supervisors looking to diversify their career
  • supervisors from culturally and linguistically diverse backgrounds
  • ACRRM supervisors.

If you would like to know more email me at chair@gpsa.org.au

Yours in Training,

Dr Nicole Higgins

GPSA Chair

Chair’s Report January 2022

Nicole Higgins
GPSA Chair, Dr Nicole Higgins

New year brings new registrars, renewal and optimism

In the words of the late Don Chipp, the founder of the Australian Democrats, he talked about ‘keeping the bastards honest’. This relates to minor parties playing a role of keeping the major parties true to their word. This is the role of an independent GPSA in the GP Training landscape.

For the past 16 months GPSA has negotiated the terms of the transition for supervisors and training practices with RACGP, ACRRM and government. With the colleges and the Department of Health currently negotiating the money and the KPI’s, GPSA will ensure that supervisors’ voices continue to be heard.

The independent role of GPSA will be pivotal as training moves back to colleges to assist supervisors with industrial support, resources and advocacy for its 8500 members and 3500 training practices across Australia.

In January, RACGP became the sole member of GP Synergy. GPSA sought members’ feedback, the vote was delayed and a better outcome was reached for the parties involved. There is now a transition plan in place in NSW for both RACGP and ACRRM registrars which minimises the loss of key staff, medical educators and local knowledge.

GPSA will be watching closely how this plays out and what happens with the other RTO’s.

The independent role of GPSA will be pivotal as training moves back to colleges to assist supervisors with industrial support, resources and advocacy

Dr Nicole Higgins

A new year brings new registrars who bring renewal and optimism. As a supervisor, this means increased demands on your time as you orientate and support them through their first weeks in your practice. GPSA has free resources which can be downloaded through our website. Whether you need NTCER compliant employment contracts, policies, procedures and teaching resources, we have you covered.

I welcomed GPT1’s Win and Anna this week. It was a lovely distraction from the stresses of Covid and day to practice. I was inspired by my kid’s teacher who gave new charges a Survival kit. I would love to hear what your practice does to celebrate the arrival of new registrars.

In December and January two new guides were sent out to training practices:

Both guides are now available free to download on the GPSA website. Every GP training practice was sent a hard copy of these new guides as a thank-you from GPSA.

Do you want to be the best training practice that you can be?

GPSA have published resources for training practices to self assess the quality of your clinical learning environment. As we know, holding an accreditation certificate alone is not equivalent to a quality learning environment. Not only will working through the resources support you to identify opportunities for improvement but it will also provide you with an effective evidence base for your accreditations into the future. These resources are available on this page: https://gpsupervisorsaustralia.org.au/gpcle-practice-setup/

Don’t be a stranger. GPSA staff are here to support you throughout your supervision journey. If you need something clarified or support to resolve an issue we encourage you to contact us on admin@gpsa.org.au or via the office landline on 03 5440 9077.

So it is with cautious optimism that I welcome the 2022 training year.

Yours in training,

Dr Nicole Higgins

GPSA Chair

Chair’s Report December 2021

Nicole Higgins
GPSA Chair, Dr Nicole Higgins

You made the difference this year – Thank YOU!

Merry Christmas to you and yours this Christmas! The deluge of work all GPs, including supervisors, registrars and their support teams have sat before throughout 2021 have exemplified how to eat an elephant… one bite at a time. 
 
General Practice once again performed like the veritable jewel in Australia’s health care crown delivering well over half of all covid vaccinations nationally whilst keeping up with our regular patients health care needs.
 
What General Practice and GP supervisors do best is get on with the job, often in undesirable conditions, but we do it anyway. While the colleges, the Department and stakeholder organisations go into bat for the very best outcomes for general practice, You keep everything going. And you will be the ones to keep everything going despite the ever shifting sands of transition to profession led training which is now 12 months away.
 
When we speak on your behalf we do so with the many frank discussions and often frustrated voices of our members in the memory and behind every word we write. You seek respect, recognition and reward for the many clinical supervision hours that are provided completely unpaid.

When we speak on your behalf we do so with the many frank discussions and often frustrated voices of our members in the memory and behind every word we write.

Dr Nicole Higgins

While 2022 will have its challenges, there have been some wins in 2021. GPSA have long advocated for greater resources and consistent remuneration for GP supervisors who perform the same role nationally. We do so because from every supervisor survey we have ever conducted you tell us it is important. And… because strangely GPSA and more recently GPRA have advocated almost uniquely for appropriate resourcing of GP supervision.

GP Training Grant Opportunity

We will be communicating with the colleges and the department in the new year about the grant opportunity they will be responding to. Notably registrar satisfaction of supervision is a KPI. Our feedback about this item is simple:

Clinical supervision is completely unpaid. So exactly what meaning will the colleges and the department apply to a registrar’s satisfaction or dissatisfaction of the supervision provided when the supervisor provides that supervision at a cost to themselves?

While we have all been waiting to see what is in store in the new world order of GP training, now the pressure rests with the colleges to put forward a funding proposal that adequately meets supervisor and registrar needs.

GP supervisor Professional Development

The non negotiable elements for GPSA are supervisor professional development opportunities that are not less than what is currently available via each RTO. GPSA cannot stress the importance of face to face peer networking and education. This needs to be adequately funded and facilitated. We cannot and should not accept online education and networking as the default.

Nationally Consistent Payment Model about to be announced for 2023

Shortly the Department of Health will release an advisory for National Consistent Payments for Supervisors, Teaching Practices and Registrars. There is a lot to like about the new package.  While most supervisors and training practices will receive an increase in teaching payments from 2023 as far as we can see no one will be worse off than they currently are and there will be, for the first time ever, national consistency; Equal pay for equal work.

Rural practices will see the most dramatic increases and this recognises the complexity in attracting and retaining supervisors in rural and remote locations and thereafter the additional work involved in supporting a registrar in a rural and remote location.

GP Synergy EGM

This month saw GP Synergy propose an amendment to its constitution, which sought to remove all members other than the RACGP. GPSA ran a survey of NSW members to seek your views ahead of the EGM vote. We did not seek to convince you one way or another because as a membership organisation our members are ultimately who inform our decisions. Wisely, GP Synergy adjourned the proposed EGM on 22 December until 20 January 2022 to further communicate their reasoning with you and its members.

What this represents is: Your voice is clear, concise, consistent and it matters!

Many of us will be working over Christmas to afford our teams the break they so deserve after a couple of relentless years – Thank you if you are doing this for your team and your community. For others please enjoy your hard earned break. Replenish and please stay safe.

The GPSA team and Board have worked hard to deliver for the membership throughout 2021. From all of us, may your Christmas cup runneth over, be bright, joyful and filled with cheer.

Merry Christmas!

Sincerely,

Dr Nicole Higgins

GPSA Chair

Supervisor Profile - Dr Graham Toohill

Dr Graham Toohill
Pictured: Dr Graham Toohill with registrar Dr Melissa Lee

Dr Graham was recently recognised by GPSA for over 25 years of service as a GP Supervisor. He has worked at Leongatha Healthcare since 1994 after working in Nepal for 12 years. He is married to Sue and they have 5 children and 4 grandchildren. Graham has special interests in Skin Clinical work and Travel medicine.

Recognition Reward Program

GPSA Reward and Recognition program

The GPSA reward and recognition program recognises the hard work and dedication of GP supervisors. If you are are a GP supervisor with over 10 years of supervising experience, we would like to recognise your dedication to nurturing the next generation of family practitioners. To nominate, you must be accredited by the Royal Australian College of General Practitioners (RACGP) and/or the Australian College of Rural and Remote Medicine (ACRRM) to train GP registrars engaged within the Australian General Practice Training program.

Nominated GP supervisors will receive:

  • Recognition of Service Award
  • ‘Training Practice is a Quality Practice’ Poster
  • Media release advising local MPs and your local media of your service to the community

To nominate a GP supervisor or yourself please click the button below

What rewards do you feel you have gained from GP Supervision ?
I really enjoy it and and get a lot of satisfaction seeing registrars getting more confident in their skills and experience. It is incredibly rewarding if they come back to Gippsland and practice here, with several previous registrars still practicing in the clinic today.  

What type of things do you feel you have learnt from GP registrars?
GP registrars all come at different stages of experience. One guy had worked in plastic surgery previously. It was terrific to see him take off a skin lesion on somebodies’ ankle which looked very difficult to close. He did a horizontal mattress suture and I have learnt from that and used this technique ever since and taught it to other Registrars. We also have lunchtime teaching sessions, where registrars prepare a relevant topic to present which they have researched.  I really enjoy these sessions where I always learn something.

What are the challenges of GP supervision?
It’s a challenge to stand back and watch a registrar do things in the practical procedure department, because you never know what they are going to do, and you know you could do it quicker and easier yourself. But you have to give registrars the opportunity to try things and learn in this way. I tell registrars that my door is always open to them and they do come in and interrupt me quite regularly. Patients are very supportive of this and do not mind. One of my current GPs said when he was a registrar, their GP supervisor told them never to interrupt him. I aim be the opposite, with an open-door policy and even though this can be challenging at times, it’s still worth it.

What are the differences working as a GP supervisor in a regional location?
There are much broader education opportunities in regional practices with a local hospital for admitting patients to and continuing to monitor them, rather than sending off to a hospital somewhere else. Registrars get to experience the full range of services in the clinic, including obstetrics, early childhood care and following through the life course up to geriatric and palliative care. All these areas are available to registrars who come here. There is also a terrific ambulance service if patients need to be sent elsewhere. Registrars can learn in all areas of medicine including assisting with caesarean sections, anaesthetics and skin cancer surgery. There are very broad opportunities to learn holistic medical care at all stages of life.

Do you have any anecdotes of a good supervision experience that you would like to share?
I had a registrar here on an ACRRM program who needed to tick off on completing a skin excision with flap repair. About this time I found a growth on my leg and a biopsy revealed it turned out to be a skin cancer. I suggested that this was the perfect opportunity for my female registrar to complete her training in this area. She did the excision and flap on my leg and did a great job. I was very impressed by this registrar and her approach.

How has GPSA Supported you?
GPSA was most helpful to me during supervisors networking weekends. We had some terrific weekends with lectures and workshops and networking. GPSA’s support and input in these weekends was excellent and the main way I have felt directly supported by GPSA.

What would you say to others considering becoming a GP supervisor? Definitely go for it! It’s a wonderful role getting to know someone and gaining trust in them and vice versa. Helping with difficult cases and teaching your knowledge is extremely rewarding and I would recommend being a GP supervisor to anyone who wants to give it a go and have a part in training the next generation of GPs.

Supervisor Profile - Dr Alvin Chua

Dr Alvin Chua
Pictured: Dr Alvin Chua

Dr Alvin Chua was recently recognised by GPSA for over 17 years of service as a GP Supervisor. Dr Chua graduated from The University of Adelaide in 1997 and has a wealth of experience in hospitals across South Australia including Modbury Hospital and Lyell McEwin Hospital; and various general practices in rural and metropolitan suburbs of Adelaide. Dr Chua became the founder of the Health at Group in 2001, with fellow Director and Practice Principal Dr Anna Schettini, and currently works at Health at Campbelltown in South Australia, In 2004 Dr Chua graduated Musculo-Skeletal Medicine at Flinders University, and continues to have an interest in Musculo-Skeletal Medicine. Dr Chua is a GP Supervisor through the GPEx Training Program.

Recognition Reward Program

GPSA Reward and Recognition program

The GPSA reward and recognition program recognises the hard work and dedication of GP supervisors. If you are are a GP supervisor with over 10 years of supervising experience, we would like to recognise your dedication to nurturing the next generation of family practitioners. To nominate, you must be accredited by the Royal Australian College of General Practitioners (RACGP) and/or the Australian College of Rural and Remote Medicine (ACRRM) to train GP registrars engaged within the Australian General Practice Training program.

Nominated GP supervisors will receive:

  • Recognition of Service Award
  • ‘Training Practice is a Quality Practice’ Poster
  • Media release advising local MPs and your local media of your service to the community

To nominate a GP supervisor or yourself please click the button below

What rewards do you feel you have gained from GP Supervision ?
Being able to shape the future of general practice and replace the workforce. Teaching and encouraging people who might look after us in the future is satisfying. I am always learning something everyday and I believe that the day you stop learning is when you become arrogant and dangerous, and you should stop practicing. As a GP you are always learning every day more than other professions, and registrars teaching us as well is a part of this.

What type of things do you feel you have learnt from GP registrars?
The current cohort of registrars put more emphasis on work life balance than my generation. In my time people put in 40-50 clinical hours plus overtime. This generation have a much better work life balance which people of my generation need to work on. Hopefully this prevents more burnout in the future, which I see in my generation with GPs sometimes becoming burnt out, bitter and cynical. The new generation has a much better perspective on work-life balance.

What are the challenges of GP supervision?
The biggest challenge is trying to compete with a dwindling workforce, competing with hospitals which offer much more generous remuneration. This makes it hard to compete for trainees. The GP workforce is dwindling and remuneration is tied into Medicare rebates. Hospitals have been able to increase 3-4% per annum when Medicare rebates were frozen from 2012-19, making us behind the eight ball and trying to catch up. The lack of exposure to general practice in medical training, with only 2-3 weeks during medical school leaves a lot to be desired. Previously, we had the Prevocational General Practice Placements Program (PGPPP) which ran from 2004 to 2014. Under the PGPPP, during their internship, registrars were allocated to a general practice for twelve weeks at a time. A lot of the registrar cohort in this time ended up as GPs and later trained other GPs as well. I was sorry to see that program go, and the whole GP workforce were sorry to see it go. The government does not seem interested in reinstating this program. Generally, there’s an expectation from Government that GPs continue to do things with altruistic values with lower expectation of monetary rewards. This is one of the biggest struggles we face as a profession.

How has GPSA Supported you?
GPSA has supported GP Supervisors like myself with negotiation of the National Terms and Conditions for the Employment of GP Registrars (NTCER) with GPRA. This sometime involves pushback when registrars have their own agendas and we as GP supervisors have our own limitations of what we are able to pay for registrars. GPSA tries to adopt an approach of all of us working together in general practice, not a ‘them’ vs ‘us’ mentality. In the past registrars adopted a ‘them’ vs ‘us’ approach which was not very conducive to working together.

What would you say to others considering becoming a GP supervisor?
 Get your feet wet and get into it. You’ll find its quite rewarding and the rewards far outweigh the challenges. Registrars are future colleagues of ours and also our future workforce.

Research – What does GP Supervision cost?

Cost of Supervision Research

GPEx, in association with the University of Adelaide and GPSA, are undertaking a study on the financial costs and revenue associated with teaching and supervision in Australian general practices [link to project clarification document on GPSA website]. First, we want to extend our thanks to the supervisors and practice managers who have been involved in this project.

We have finished interviewing supervisors and practice managers and found that often “teaching a registrar takes a village”. The substantial investment from the supervisor/s and the practice manager were evident. Practice level (eg., having experienced supervisors) and system level (eg., having a suite of resources) factors were seen to enable the teaching and supervision of registrars.

An important theme was that this is not a “one size fits all” model and there was substantial variation across practices. Practices and supervisors want to retain registrars after training and are invested in developing the future GP workforce because they love teaching. These findings informed the development of an online national survey, for which data collection has concluded. A cost revenue analysis is underway and a report of the findings will be available in 2022.

Below are some of the key findings so far:

What the practices said:

  • It’s not just the supervision and teaching
  • The practice manager invests substantial time too
  • Teaching a registrar takes a village
  • There are other financial and non-financial costs
  • It is difficult to quantify
  • It is not a one size fits all model
  • It is part of a complex bigger picture

What makes it easier….

    Practice level 

  • Patient scheduling
  • Experienced supervisors and practice
  • Flexible practice
  • Efficient medicare billings
  • Relationship with registrars

    System Level

     

  • Available suite of resources
  • Supervisors engaging in activities they enjoy and see the value in
  • Practice-registrar fit
  • Multiple registrars
  • Opportunity for longer placements

Why do we do it?

  • Keeping registrars after training
  • Keeping up to date
  • Intrinsic motivation to support the development to training our future GPs
  • The love of teaching

Visit the GPSA Research page for future updates on this research and it’s findings.

Chair’s Report December 2021

Nicole Higgins
GPSA Chair, Dr Nicole Higgins

Value your worth!

Last week RACGP President, Dr Karen Price, called for GP’s to move away from universal bulk billing. GP training practices already take a financial hit to train the next generation of family doctors. How do we ensure that our training practices are viable?

The Medicare rebate belongs to the patient. It is the patient who is being penalised when the Government fails to keep up with inflation. To ensure that the practice can remain viable, practices may privately bill and the patient has a gap to pay.  When we bulkbill, we accept the rebate as full payment on behalf of the patient. It simply does not cover the bills.

Training practices go above and beyond in providing a service to the community. Value your worth.

Dr Nicole Higgins

The lack of investment in Medicare, the Medicare freeze and the overall underfund in GP training impacts on our ability to provide quality general practice training.

Patients make over 120 million visits to GPs every year. There is an election in the air.  Now is a good opportunity  to educate our registrars, colleagues and patients on what universal bulk billing means and the impact that it has on our ability to provide quality medical care and training.

Transition to Profession Led Training

Grant opportunities have been released for workforce agencies called GPWPP (Workforce Priority and Planning). These GPWPP will decide on workforce needs and determine where registrars will be placed. It will be up to the colleges to allocate a registrar to the identified placement. As yet we do not know who these GPWPP will be. We do know that workforce areas will be aligned with PHN boundaries. GPSA is concerned that money will be taken out of the AGPT training bucket of money to fund these agencies and that workforce need will take priority over quality of training experience. The allocation of registrars under AGPT will remain at 50% for MM1 and 50% for MM2-7.

The good news for supervisors is that the Government has recognised the importance that we play in GP training. The Nationally Consistent Payments system means that for most supervisors and training practices remuneration will be increased and nobody will be worse off which is great news in a limited training budget.

GPSA has strongly advocated for our members with the Department of Health and with the colleges during negotiations in the Transition to Profession Led Training.

NTCER

GPSA and GPRA have started discussions on reviewing the NTCER. We have a good working relationship and have developed a set of principles to support a collaborative negotiation. Both organisations have the best interests of the future of GP training as the focus of negotiations. Separate to the NTCER, we have been advocating for a paid parental leave scheme at GPTAC (GP Training Advisory Committee) with GPRA, RACGP, ACRRM and AMA. This has progressed and I am looking forward to some great news by mid 2022.

SLON Meeting

Our Supervisor Liaison Network met via Zoom last week. We thank Martin Rocks and Dr Susan Wearne for attending from the Department of Health and for providing an update on GP training and answering questions. We also thank the Department for continuing to fund the network. Both colleges provided an update on transition. The SLON is a valuable resource which provides feedback to GPSA and decision makers as well as supervisors on the ground.

I thank our supervisors and practice managers for their support this year. I have missed seeing you all face to face. The team and the board at GPSA have worked tirelessly behind the scenes to ensure that supervisors have a voice and are heard.

Yours in Training,

Dr Nicole Higgins

GPSA Chair

Supervisor Profile - Dr Paul Mercer

Dr Paul Mercer
Pictured: Dr Paul Mercer

Dr Paul Mercer has enjoyed a long and varied career as a GP Supervisor since 1988 supervising 78 registrars during this time. Since establishing Silky Oaks Medical Practice in Manly west, Queensland in 1987, Paul has developed skills in chronic disease care, addiction medicine, mental health care, palliative and aged care, and minor procedures. Paul is aware of a maturity that has grown through the experience of registrar teaching. This has allowed the development of material for conference presentations around such topics as “Wisdom & Learning” and “Curiosity & Learning” in registrar training and teaching a number of Doctor’s Health workshops. Paul is currently involved in a GPTQ research project looking at the teaching of doctor’s health in the registrar training experience.

Recognition Reward Program

GPSA Reward and Recognition program

The GPSA reward and recognition program recognises the hard work and dedication of GP supervisors. If you are are a GP supervisor with over 10 years of supervising experience, we would like to recognise your dedication to nurturing the next generation of family practitioners. To nominate, you must be accredited by the Royal Australian College of General Practitioners (RACGP) and/or the Australian College of Rural and Remote Medicine (ACRRM) to train GP registrars engaged within the Australian General Practice Training program.

Nominated GP supervisors will receive:

  • Recognition of Service Award
  • ‘Training Practice is a Quality Practice’ Poster
  • Media release advising local MPs and your local media of your service to the community

To nominate a GP supervisor or yourself please click the button below

What rewards do you feel you have gained from GP Supervision?
In a GP Supervisor career spanning over 33 years, I have gained many rewards from working intensively with registrars, experiencing great camaraderie and enjoyment as well as developing my professional skills. Learning and developing teaching skills in the real world has been a major part of this journey. In my practice we adapted our GP training approach to incorporate vertical integration, so that medical students can learn both from GP supervisors and registrars in the practice. Developing a practice culture where everyone values learning, including the patients was a major part of this. I developed my skills in team building in the practice through this process. I enjoyed sharing a meal with each registrar at the start and end of their term which helped in establishing strong working relationships with them. Overall, working as a GP supervisor has kept me fresh and current in my clinical practice, as well as establishing firm friendships, attending weddings, and celebrating births of children of registrars I have trained.

Do you feel that you learn from GP Registrars also? If so, what type of things have you learnt?
I have learnt a lot from registrars over the years, including finding out more about different learning styles they may have, and developing different teaching and learning planning approaches to accommodate this. Some registrars were particularly good at planning their own learning and I learnt a lot from them. Thanks to being responsive to their enthusiasm to learn, I have managed to maintain close to cutting edge medicine in my own practice. I have enjoyed learning from the specialty skills some registrars may have acquired before joining our practice. I also learnt a lot from education and training conferences and workshops which formed a background to my 1 to 1 teaching. Learning from GP supervisor peers and gaining encouragement from them helps generate wisdom. I also learnt research skills through my involvement with some registrars.

What are the challenges of GP supervision?
The main challenges are balancing the competing demands of managing a practice, having a growing family, seeing patients and training registrars. My wife has had to warn me at times to keep these different areas under control. It is always hard to take leave when I am tired if I know that a registrar is struggling and there is no-one else to supervise them. Learning to teach outside of my own particular learning style was also a struggle but allowed me to mature as a teacher. The emotional challenges of registrars and issues they may be having were also problematic at times. Managing patients with misunderstandings of different experience levels of doctors has also been challenging. Rostering and admin also provided challenges, and delays in money for training coming through can also be frustrating. At times I have worked with registrars who may have particular needs and it has been rewarding to see every one of them go on and succeed under my guidance. This includes working with IMG registrars who have cultural and communication issues, and differences in their basic training that need to be understood and worked through respectfully.

Do you have any anecdotes of a good supervision experience that you would like to share?
At one stage I managed to catch my left foot under a ride on mower and was in hospital for a while before recovering at home. At the time it was great to see how gracious and supportive the registrars were, coming to my house for teaching sessions and ringing up for phone support if needed, as well as keeping the practice running. One registrar I worked with had their whole world collapse when their father who was also a GP died during the middle of their training term. It was an honour to support them through the difficult time after this tragedy and then see a flourishing unfold as a GP in their father’s practice. Another registrar used their lunch break to train an ocean swimming race. She was very successful at this first attempt.

How has GPSA Supported you?
I recognise the solid value of peer support networks that GPSA provides, as well as negotiating conditions for us where we don’t have the time to do this. Many of the teaching skills documents I have used have been good and useful, in particular the Ethical Dilemmas flash cards which I have found a great tool for teaching different scenarios. Conferences and other networking opportunities to speak face to face with other supervisors have been invaluable.

What would you say to others considering becoming a GP supervisor?
There are amazing career opportunities to being a GP supervisor. It is a role which helps in keeping up to date and challenges your own communication and clinical skills. Learning to teach others adds a layer of depth to your knowledge. It offers a goldmine opportunity to provide authentic mentoring not found in many other disciplines anymore. This is Hippocratic medicine at it’s best in the new world of evidence-based medicine.