Overview of AGPT registrar training... 3 RACGP TRAINING PATHWAY The curriculum... 4 Overview of RACGP training pathway... 4

Transcription

1 Practice Manager Handbook 2015

2 Disclaimer: This information has been produced to assist those persons who are participants in the QRME GP Training Program. Every effort has been made to ensure the information is accurate. QRME is not responsible for actions arising from information contained in this Handbook.

3 Contents OUR MISSION... 1 OUR AIM... 1 QUEENSLAND RURAL MEDICAL LONGLOOK PROGRAM (QRMLP) VERSEAS TRAINED DOCTORS NATIONAL EDUCATION AND TRAINING PROGRAM (OTDNET)... 2 AUSTRALIAN GENERAL PRACTICE TRAINING (AGPT)... 3 Overview of AGPT registrar training... 3 RACGP TRAINING PATHWAY... 4 The curriculum... 4 Overview of RACGP training pathway... 4 ACRRM TRAINING PATHWAY... 5 From the beginning of a registrar s training... 5 Mandatory rotations... 5 HOSPITAL TERMS (RACGP) AND CORE CLINICAL TERMS (ACRRM)... 6 GENERAL PRACTICE TRAINING TERMS FOR RACGP AND ACRRM... 7 Requirements for GPT1/ PRRT Requirements for GPT3/PRRT Requirements for Extended skills or GPT4/PRRT FULL-TIME EQUIVALENT TRAINING... 8 IN PRACTICE TEACHING FOR THE REGISTRAR... 9 ORIENTATION: THE REGISTRARS FIRST WEEK IN THE TRAINING POST... 9 Day 1: Sit in with Supervisor... 9 Day 2: Minimum half day with practice manager and half day with supervisor... 9 Day 3: Minimum half day with the nurse and half day in consulting room Day 4: Half day tour and half day consulting Day 5: Consulting along with 3 reviewed consultations by the supervisor Week 2 and beyond FORMULATING A REGISTRAR LEARNING PLAN RESOURCES ATTENDANCE AT PRACTICE TEACHING Direct observation by the supervisor General Information Mandatory DOTs Highly recommended DOTs Formulating a registrar learning plan... 13

4 Completion of QRMe-learning (online modules) QRMe-learning Plan Direct observation by medical educators Audit - Registrar Clinical Encounter What can be my snap-shot of a working week? How many entries do I need to log? What about when I work in a hospital, nursing home or elsewhere? Do I record after-hours work? Procedural log Multi-Source Feedback and Professionalism Optional Tele-Internal Medicine Teaching Optional Telederm Teaching OUT OF PRACTICE TEACHING Residential Workshop 1: GP Survival Residential Workshop 2: Rural General practice Workshop Monthly small group Exam preparation workshop Other Training Terms Advanced Specialised Training for ACRRM Registrars Mandatory Elective Time Completion of Training Extension (COT Extension) OPTIONAL TRAINING Advanced Rural Skills Training FARGP Research project Non-QRME educational events Training Advisors (TA s) External Clinical Teaching (ECT) Visits COMMUNICATION FINANCIAL CONSIDERATIONS TRAINING POST PLACEMENT CONFIRMATION OF EMPLOYMENT Hospital-Based Registrars MEDICAL INDEMNITY INSURANCE MEDICAL REGISTRATION FEEDBACK AND PROGRAM EVALUATION... 24

5 SUPPORTING THE REGISTRAR FINANCIAL INFORMATION TRAINING POST SUBSIDY TEACHING ALLOWANCES Teaching Allowances for Supervisors in GPT1/PRRT1 Term Teaching Allowances for Supervisors in GPT2/PRRT2 Term GPT1/PRRT1 Term GPT2/PRRT2 Term PROFESSIONAL DEVELOPMENT FOR MANAGERS ACCREDITATION OF TRAINING POSTS DURING CHANGE TO ASGC-RA SYSTEM DISTRICT WORKFORCE SHORTAGE INTERN TRAINING QRME KEY DATES ORIENTATION AND INDUCTION HOW PRACTICE MANAGERS AND STAFF CAN ASSIST A REGISTRAR TIPS FOR PRACTICE MANAGERS ORIENTATION / INDUCTION General Checklist Prior to Commencement of the Registrar AN ORIENTATION PACKAGE GUIDE Registrars should be orientated to the training post suggested checklist as a guide APPENDIX 1 - LIST OF ACRONYMS APPENDIX 2 RECOGNITION OF PRIOR LEARNING (RPL) APPENDIX 3 - LEARNING PLANS APPENDIX 4 GENERAL MEDICINE TEACHING A REGISTRARS PERSPECTIVE What is it? Who provides it? Who is it for? What sort of patient should I choose? What data are we recording? How do we bill? How do I do it? What if I want to talk to a human instead of reading a FAQ? APPENDIX 5 - USEFUL APPS, RESOURCES AND STUDY LINKS QRME Online... 41

6 Calendar Quickbase Australian Medicines Handbook Other websites APPENDIX 6 QRME CONTRACT WITH REGISTRARS QRME Registrar requirements APPENDIX 7 - REQUIREMENTS FOR COMPLETION OF TRAINING RACGP Registrars ACRRM Registrars APPENDIX 8 - QRME CONTACTS FOR MANAGERS Medical Education Team Key Support and Administration APPENDIX 8 - QUICKBASE MANUAL FOR PRACTICE MANAGERS Introduction Location Access Password Creation QuickBase My Apps Practice Manager Home Page Navigation Ribbon Activity Data Sheets Expense Claims Training Site Placement Requirements Practice Subsidy Invoices Reports Activity Data Sheets Add Activity Data Sheet Entering Data Training Details Activity data items Other Educational Activities Registrar Leave Items Supervisor Leave Items Is the Sheet ready for Supervisor & Registrar to verify? Verification Submission... 53

7 Invoicing Locate invoices Teaching Allowance Invoice Practice Subsidy Invoice Reports available My Registrars report My Activity Data Sheets My Remediation, Incident or Complaint Report My Expense Claims report s Generated New Activity Data Sheet added confirmation New Activity Data Sheet added Supervisor verification New Activity Data Sheet added Registrar verification Activity Data Sheet verification completed Activity Data Sheet Ready for Submission APPENDIX 9 CLINICAL IMAGES AND THE USE OF PERSONAL MOBILE DEVICES Collections, use and disclosure of clinical images taken with a personal mobile device Storage and security of clinical images... 56

8 Our Mission Rural Medical Education Better Health for Communities. Our Aim To provide a high quality program of rural general practice and rural medical vocational training. To provide access to education and training for overseas trained doctors supporting attainment of general medical or vocational registration as a general practitioner. To increase support provided to Aboriginal and Torres Strait Islander health training facilities in AGPT. To support regional and rural medical education for medical schools. To support supervisors, practice managers and rural practices and rural hospitals training posts to develop and sustain clinical supervision of students and registrars undertaking rural medical education. To evaluate rural medical educational activities and undertake medical research relevant to rural health. To conduct the business of rural medical education with good corporate governance in a fiscally prudent manner with good business practice. 1

9 Queensland Rural Medical Longlook Program (QRMLP) QRMLP is an innovation in Queensland for medical student clinical training. Modelled on Flinders University's Parallel Rural Community Curriculum Program, QRMLP is a shift in terms of both geography and duration of medical student placement. The intention of the program is to provide Griffith University, University of Queensland and Bond University students with a well supported long look at rural medicine in towns on the Darling Downs and in the South Burnett region. This type of program has been shown to positively influence students' long term specialty and location intentions towards rurally-based primary care roles. Following a successful pilot and introductory year in 2012, 4th year students on the program are in hospitals and training posts for weeks in the towns of Crows Nest, Clifton, Millmerran, Goondiwindi, Oakey, Cherbourg, Blackall and Gatton. 3rd year QRMLP students will be spending the whole 42 weeks of their academic year in Beaudesert, Stanthorpe, Roma, Warwick, Kingaroy and Dalby. One of the reasons that QRME is involved is to support rural training posts and hospitals with the growing responsibility of training medical students. Longer placements for students require less orientation time. Within 4-6 weeks students on a week placement can become a functional member of your training post, performing clinical and organisational tasks that can free up other medical staff. If you are interested in your training site participating in the program or if you have any feedback about your current involvement, please contact QRMLP on or qrmlp@qrme.org.au. 0verseas Trained Doctors National Education and Training Program (OTDNET) The QRME OTDNET Program assists OTDs to prepare for Fellowship of either the Australian College of Rural and Remote Medicine (ACRRM) and the Royal Australian College of General Practitioners (RACGP). The OTDNET Program is a comprehensive program designed to prepare OTDs for College examinations. OTDs are provided access to QRME s extensive education and training resources, including its online programs (QRMe-learning), QRME workshops, study groups, and webinars. The webinars cover the general practice training curriculum and the domains. There is a focus on Aboriginal and Torres Strait Islander Health, the Australian culture, patient safety and the context of general practice in Australia, communication, and interpersonal skills. OTDs have access to a dedicated and experienced Medical Educator who will design and construct a learning plan for the OTD, provide feedback and ensure that OTDs receive an external clinical teaching visit throughout the duration of the Program. OTDs typically spend 12 months on the Program in preparation for their exams. OTDs participate in fortnightly webinars that generally covers the RACGP and ACRRM curricula. In most webinars, OTDs practice clinical and KFP-style questions and take it turns to work on a case. The medical educator provides feedback and coaches the OTD on how best to develop a case by methodically working through a consult structure. To be eligible, an OTD must have a combined general practice experience of at least 2.5 years (including overseas experience). The College s require that an OTD have a minimum of 4 years GP experience (of which 12 months must be in Australia) by the time that the exam is to be sat. 2

10 QRME prefer that OTDs have general registration (we will also consider applicants with limited registration) and that applicants are permanent residents or Australian citizens (or working toward becoming a citizen or permanent resident). An Australian Government scholarship is available to support the cost of the Program for each OTD. QRME has 20 such places available throughout The out-of-pocket expense per applicant is $4500 (which can be partly recouped through the ATO s self education expenses). Some practices have access to professional development funds which can be used to support applicants. For further information see QRME s webpage at: or contact Brendan Grabau at b.grabau@qrme.org.au or AUSTRALIAN GENERAL PRACTICE TRAINING (AGPT) Overview of AGPT registrar training The GP training program is a 3 or 4 year program depending on which fellowship registrars choose to pursue. 3

11 It is easier to plan GP training if the registrar knows which fellowship is being sought. QRME recommends that all registrars become a member of one or both colleges from the beginning of training. This has a number of advantages including access to resources which are invaluable for good training post and for exam preparation. If a registrar chooses ACRRM as the preferred fellowship pathway, they are required to become an ACRRM member immediately. If registrars don't know whether to align with RACGP and/or ACRRM; there is no need for panic - there is still plenty of time. The registrars training advisor will be able to guide them as to the best fit. AGPT allows for some flexibility during the training program including sequencing of terms, up to 12 months leave, part-time training and academic terms. Registrars may pursue both pathways concurrently. QRME will tailor training to fit the registrars specific needs. The training plan will need to be aligned with AGPT policy and will need to meet the requirements of the chosen college. The policies and procedures for AGPT can be found at: College requirements can be obtained from: and RACGP training pathway The curriculum The overall learning objectives of the RACGP curriculum are organised into five broad interrelated domains of competence. Remember these 5 domains - all teaching and learning will be linked to these: 1. Communication skills and the patient-doctor relationship 2. Applied professional knowledge and skills 3. Population health and the context of general practice 4. Professional and ethical role 5. Organisational and legal dimensions. Overview of RACGP training pathway 4

12 ACRRM training pathway Registrars wishing to train towards FACRRM must first enrol as a member of the college. The ACRRM Primary Curriculum describes the core learning outcomes which must be attained to be eligible for Fellowship of ACRRM. Detailed information on the ACRRM Curriculum can be found at: The overall learning objectives of the ACRRM curriculum are organised into 7 broad interrelated domains of competence: Provide medical care in the ambulatory and community setting Provide care in the hospital setting Respond to medical emergencies Apply a population health approach Address the health care needs of culturally diverse and disadvantaged groups Practise medicine within an ethical, intellectual and professional framework Training post medicine in the rural and remote context. ACRRM training requires 3 spheres of learning and experience to ensure the registrar is exposed to a range of learning environments necessary to meet fellowship standards: Core Clinical Training Primary Rural and Remote Training Advanced Specialised Training. From the beginning of a registrar s training Mandatory rotations All registrars in their hospital time (during PGY1 and onwards) must have at least 10 weeks of experience in each of the following mandatory rotations before starting GP training at GPT1/PRRT1: General Medicine or a rotation that offers broad medical experience such as geriatric medicine General Surgery or a term that covers the principles of basic surgical care Accident and Emergency Paediatrics o The paediatric term requirement for RACGP may be fulfilled in either: Full week paediatric term A half paediatric term (minimum 6 weeks in length) with an approved full (10-12 week) Emergency Department (ED) with 20% paediatrics Two ED terms with 20% paediatrics. One term may be undertaken in Post Graduate Year 1 (PGY1) if the other is undertaken in Post Graduate Year 2 (PGY2). Completion of the coursework and exam for the Westmead Diploma in Child Health. The full RACGP paediatric term requirements can be found at: 5

13 ACRRM registrars are required in addition to have full terms of: Anaesthetics Obstetrics and Gynaecology (including 20 normal or simulated deliveries) Both Colleges account for 4 weeks annual leave in a training year. Hospital terms (RACGP) and core clinical terms (ACRRM) The first year of GP training takes place in an Australian accredited hospital after receiving general registration in Australia. Junior doctors can apply for a position on the AGPT program as an intern and undertake their second year (PGY2) as part of their GP training. Doctors applying later than their intern year may be eligible to apply for recognition of prior learning (RPL) and either not have to do additional hospital time or in some circumstances reduce their GP training time. Further information on RPL is available in Appendix 2. GP Registrars are responsible for arranging their own hospital placements. The training requirements during hospital terms are aimed to help registrars understand GP training and to assist with their transition into community general practice. The registrar s training is facilitated by a QRME GP Hospital Liaison Officer (HLO). There are 5 requirements of training during the hospital year (or prior to commencing general training post): 1. Satisfactory term assessments (to be uploaded onto QuickBase prior to commencing GPT1/PRRT1). 2. Consideration of 3 general practice training questions to discuss with HLO: What is your philosophy of GP? What do your hospital colleagues and specialists think of GP s? What are the major differences between ACRRM and RACGP during training? Outline your ideal training plan for completion of your fellowship. (e.g. which college, what job and where etc. to meet training requirements) 3. Completion of 2 online training modules and 2 surveys: PBS module (2 hours to complete) MBS module (3 hours to complete) Learning style questionnaire (16 short multi-choice questions ~15 minutes to complete) Indigenous health survey (30 minutes to complete) 4. Attendance at 3 meetings with the HLO throughout the year to discuss your training and the 3 general practice training questions 5. Pre-reading for Introduction to General Practice Workshop (6 hours). 6

14 General practice Training Terms for RACGP and ACRRM Requirements for GPT1/ PRRT1 Supervision GP Supervisor must be on-site at least 80% of the time and available 100% of time by phone unless prospectively approved for remote supervision. Teaching Direct Observation by Supervisor Direct Observation by Medical Educators Workshop Learning Plan Training Adviser contact QRMe-learning Small Groups Three hours dedicated teaching and learning time each week. One hour of this time must be face to face. The foundation for this hour should be discussing QRMelearning. In first week of practice supervisor is to observe minimum of 3 consultations (live or recorded) as part of registrar clinical assessment. Each week supervisor to review minimum of one consultation and record DOT. A minimum of two half day sessions of direct or recorded observations of consultations. ACRRM registrars are to complete a minimum of 2 mini-cex during this observation time. Attend and participate in workshops or seminar program plus predisposing and reinforcing activities An achievable learning plan to be developed within first 4 weeks of term in collaboration with your supervisor and guided by Direct observation feedback. This needs to be available for review by medical educators and Training Advisers and entered or uploaded to QuickBase. To be reviewed at least once during term. Complete training adviser questionnaire and have two contacts with training adviser to discuss and review progress. Complete weekly modules Attend monthly small group meetings and prepare cases or questions as directed. Requirements for GPT2/PRRT2 Supervision Teaching Direct Observation by Supervisor Direct Observation by Medical Educators Workshop Learning Plan Training Adviser contact QRMe-learning Small Groups Audit Professionalism Exam prep/small group GP Supervisor must be on-site at least 50% of the time and available 50% of time by phone unless prospectively approved for remote supervision model. Two hours dedicated teaching and learning time each week. One hour must be face to face. The foundation for this hour should be discussing QRMe-learning. In first week of practice supervisor is to observe minimum of 3 consultations (live or recorded) as part of registrar clinical assessment. Each week supervisor to review minimum of one consultation and record DOT. A minimum of two half day sessions of direct or recorded observations of consultations. ACRRM registrars are to complete a minimum of 2 mini-cex during this observation time. Attend and participate in workshops or seminar program plus predisposing and reinforcing activities An achievable learning plan to be developed within first 4 weeks of term in collaboration with your supervisor. This needs to be available for review by medical educators and Training Advisers and entered or uploaded to QuickBase. To be reviewed at least once during term. Complete training adviser questionnaire and have two contacts with training adviser to discuss and review progress. Complete modules and attend small group learning. Attend monthly small group meetings and prepare cases or questions as directed. Complete registrar clinical encounter audit Complete CARE Measure tool or Multi-Source Feedback (MSF). In your own time 7

15 Requirements for GPT3/PRRT3 Teaching One hour each week. The foundation for this hour should be discussing QRMelearning. Supervision Direct Observation by Supervisor Direct Observation by Medical Educators Learning Plan Training adviser contact Supervisor must be on-site at least 25%, remaining 75% by phone unless prospectively approved for remote supervision model. In first week of practice supervisor is to observe minimum of 3 consultations (live or recorded). Each week supervisor to review minimum of one consultation and record DOT A minimum of one half day sessions of direct or recorded observations of consultations. ACRRM registrars are to complete a minimum of 2 mini-cex during this observation time. An achievable learning plan to be developed within first 4 weeks of term in collaboration with Supervisor Complete training adviser questionnaire and have two contacts with training adviser to discuss and review progress. Exam preparation small group In the 6 months prior to your summative assessment attend monthly small group exam preparation sessions. Requirements for Extended skills or GPT4/PRRT4 Supervision Supervisor must be on-site at least 25%, remaining 75% by phone unless prospectively approved for remote supervision model. Learning Plan Training adviser contact An achievable learning plan must be prospectively approved prior to starting extended skill and then further developed within first 4 weeks of term in collaboration with Supervisor. Learning plans for commonly completed extended skills are available on QRMEonline. Complete training adviser questionnaire and have two contacts with training adviser to discuss and review progress. Professionalism Exam preparation small group Complete of CARE Measure tool or Multi-Source Feedback (MSF) In the 6 months prior to your summative assessment attend monthly small group exam preparation sessions. Full-time equivalent training RACGP consider that full-time equivalent training is a minimum of 32 hours per week 1. Part-time is calculated as a proportion of full-time, as long as it is greater than 10.5 hours patient contact time across two days minimum. ACRRM regards full-time training to be at least 38 hours per week including any administration and education activities 2. Anything less than 38 hours per week training is regarded as part-time training equivalent. The National Minimum Terms and Conditions [2013] require you to work 38 ordinary hours per week for full-time equivalence, with at least 27 hours per week scheduled patient contact time. Note that this refers to determination of employment time equivalence, not training time equivalence [Yes, we realize this is somewhat ridiculous, however, this is the system that we have to work with]. 1 RACGP Vocational Training Standards, 2015: p39. 2 ACRRM Training Time Policy, 2013: p1. 8

16 You will be expected to participate in both on-call rostered duties and nursing home visits if required by the practice. This is considered to be a normal part of general practice (see AGPT National Minimum Terms and Conditions): QRME supports registrars being in the one training post for 12 months. RACGP requires the placement of registrars in at least two different training posts during their training. This provides the registrar with a variety of experiences, patient demographics and teaching styles. ACRRM requires registrars to work for a minimum of 6 months in community general practice. QRME provides a structured training program for registrars to assist them in delivering high quality health care to rural patients and to achieve success in their chosen fellowship exam. In practice teaching for the registrar The GP supervisor will: Introduce you to the training post Help you determine what you need to learn while in the training post Supervise your work Provide structured face-to-face dedicated teaching Act as a professional role-model Help you improve your consulting skills by direct observation and review of your consultations Reviews cases Discuss problems Assess your performance. Orientation: the registrars first week in the training post Day 1: Sit in with Supervisor On Day 1 registrars should sit in with the supervisor. (It is recommended that the registrar observe the supervisor throughout the day.) Utilise this time to ease the transition from hospital to community based training post. It is useful to discuss the context of general practice in a rural or regional area. Many components of general practice can be quite different to a hospital training post. These components may include: 15 minute appointments, electronic records, and taking ownership of decision making, undifferentiated illnesses and managing chronic disease (in particular mental health issues). Day 2: Minimum half day with practice manager and half day with supervisor On Day 2 it is suggested that registrars spend a half day with you and then sit in with the supervisor for the remainder of the day. A number of practice managers encourage registrars to sit at the front desk and shadow or be a receptionist for a couple of hours. The aim of this task is to build a relationship with reception staff and to gain an understanding of the pressures and stress of their job. Registrars should get a feel for front desk triage; booking appointments; billing policies and procedures of the training post and being familiar with general office paperwork. All registrars should take particular notice of the Policy and Procedure Manual. 9

17 Day 3: Minimum half day with the nurse and half day in consulting room On Day 3 registrars should spend half day with a nurse and half day in their consulting room. The nurse can orient the registrar to: 1. Treatment room (where dressings are located, gloves, sterilisation policy, waste disposal etc.) 2. Emergency equipment and how to seek help 3. Immunisation schedule and procedures 4. Training post policy for recalls and follow-ups 5. Policy for checking pathology and radiology results 6. Care plans 7. Minor procedure bookings Registrars should spend about an hour in their own consulting room to become familiar with the environment and have a play with a dummy patient on the computer. Day 4: Half day tour and half day consulting AM - Arrange a time to introduce your registrar to the local pharmacists, radiologists and pathologists. Organise for the supervisor to introduce the registrar to the nursing home staff, hospital staff, allied health services etc. PM - Schedule the registrar 1-2 patients/hour for the afternoon. Day 5: Consulting along with 3 reviewed consultations by the supervisor The registrar should be booked to see 2 patients per hour. The supervisor is required to observe the registrar consulting a minimum of 3 patients and complete the competency baseline. This formative assessment is used to guide the registrars learning plan and to give an indicator of the level of supervision likely to be required. Week 2 and beyond You can increase registrar patient numbers up to a maximum of 4 per hour. You, the registrar and supervisor will need to discuss progress. GP term Minimum number patients/hour Expected average number of patients/hour Maximum number patients/hour Maximum consults (all types) per F/T week 1st 3 months GP experience (GPT1/PRRT1) 2nd 3 months GP experience (GPT2/PRRT2) Further GP experience

18 Formulating a registrar learning plan Beginning training in the field of general practice can be overwhelming for any registrar. The learning plan is a written document setting out the learning; clinical experience and assessment which the registrar will undertake to develop their knowledge and skills. The learning plan is facilitated by the GP supervisor and approved by the registrars Training Advisor. The development of the registrar learning plan can be guided by a range of headings such as: What they need/want to learn When to learn it How to learn it/learning strategies How will the registrar know when this has been achieved For the first few weeks in general training post the learning plan may look like this: Complete QRMe-learning modules by date/month/year Be comfortable with management of anaphylaxis 1. Download wall chart 2. Do online allergy module 3. Simulated scenario with training post nurse and supervisor during teaching session on date/month/year Registrars are required to have a current learning plan within the first 4 weeks of each term. This learning plan is to be entered into QuickBase. (A QuickBase Start up Guide can be found in Appendix 8). The registrar learning plan needs to be updated and reviewed at least every 3 months. A sample learning plan can be found in Appendix 3. Resources QRME provides registrars with clinical resources to utilise both during consultations to improve patient care and for private study. During the registrars first weeks of practice, QRME will provide an ipad and a dermatoscope. The ipad comes with some useful clinical apps and documents. The registrar will also receive John Murtagh s General Practice textbook and access to e- resources of etg and BMJ Best Practice. A list of further resources can be found in Appendix 5. Attendance at Practice Teaching The supervisor is contracted to provide the registrar with 3 hours of teaching/week in their first 6 months. One hour of this structured face to face teaching will include discussing QRMelearning (see below). 11

19 Term 1st 6 months GP experience (GPT1/PRRT1) 2nd 6 months GP experience (GPT2/PRRT2) Further GP experience Weekly Teaching Requirements Required Face-to-Face teaching Opportunistic teaching and Registrar independent learning time 3 hours 1 hour 2 hours 2 hours 1 hour 1 hour 1 hour - 1 hour In Practice Teaching Structure QRMe-learning and formation of a learning plan Direct Observation QRMe-learning and formation of a learning plan Direct observation Exam preparation Direct observation Direct observation by the supervisor Clinical supervision of registrars requires teaching, provision of feedback and assessment. Direct observation of registrars is an essential component of supervision: a method of teaching, an occasion for feedback and an opportunity for assessment of registrars as well as being a key safety measure for a general practice or a rural hospital. General Information 1. The Registrar Clinical Assessment consists of direct observation of a GP registrar by their supervisor. It occurs within the first 2 weeks of commencing the first term of general practice. It is intended to help you and your supervisor devise a learning plan for your term. 2. A minimum of 3 consultations are observed either by direct observation or video. This does not have to be 3 consecutive patients and can be arranged at a time that suits your supervisor. It is beneficial to see more than 3 patients together if possible. Consent will be required from patients. 3. Direct observation teaching (DOT) by supervisors continues weekly for a minimum of one consultation. Mandatory DOTs 1. Registrar competency assessment in first 2 weeks of each placement 2. Common dermatological procedures 3. Antenatal consultation 4. In-practice emergency simulation scenario. Highly recommended DOTs Health check for ATSI child year old Health check Driving assessment Nursing home visit Childhood immunisation Contraception consultation Musculoskeletal exam Prenatal diagnosis counselling Prostate screening 12

20 Smoking cessation Chronic disease management plan. Registrars should be given feedback on consultations. The Clinical Assessment form has space for comments and recommendations for change. It is expected that the registrar will identify some learning needs and these will be entered in their learning plan. The Clinical Assessment form can be found at: All patients being observed or videoed must provide consent. Ideally this occurs 3 times when the patient rings to make the appointment, on arriving for the appointment and when the registrar calls the patient into the room. If video-recording patients, written consent must be obtained. Resources, including consent forms, to complete direct observation and registrar clinical assessment can be found at Formulating a registrar learning plan Each registrar is required to have a current learning plan within the first 4 weeks of each term. The learning plan needs to be updated and reviewed at least every 3 months. A sample learning plan can be found in Appendix 3. Completion of QRMe-learning (online modules) QRMe-learning is a guideline based training tool that provides a structured and systematic way to become familiar with foundational and common problems encountered within general practice. The QRME guide provides weekly modules (each with readings, supporting references and key clinical activities) that are designed to be worked through individually and then to be discussed with the GP supervisor. Every 4th week, registrars meet with other registrars (face to face or via tele/videoconference) for small group learning to discuss relevant cases relating to the topic. The QRMe-learning study plan for 2015 is outlined below. Registrars should liaise with you and the GP supervisor in order to arrange protected time in the appointment book for teaching and small group learning. QRMe-learning Plan (For information on small group learning please refer to out of practice teaching) Monthly Subject Area Pre-Workshop General practice Preparation Introduction to General practice Weekly Topic Mastering QRME IT How to use QRMEonline and QuickBase Principles of Emergency Care in General practice PBS and MBS modules Basic Communication Foundation and philosophy of General practice Small Group Learning Catch up week EDUCATION WORKSHOP 1: INTRODUCTION TO GP Undifferentiated illness in GP - Safe diagnostic strategies Difficult consultations and patients Week Commencing 19 January 27 January 27 January 02 February 09 February 16 February 13

21 Monthly Subject Area Foundations of General practice Paediatrics Women's Health Weekly Topic Small Group Learning Clinical errors and safe practice Basic Professionalism in GP Introduction to the business of GP Small Group Learning Febrile child Well child check/immunisation and feeding Paediatric rashes Small Group Learning Antenatal Care Contraception Management of menopause Small Group Learning Week Commencing 23 February 02 March 09 March 16 March 23 March 30 March 07 April 13 April 20 April 27 April 04 May 11 May 18 May Respiratory Medicine Cardiovascular System Cardiovascular System Endocrinology Population Health Preventative Health Community acquired pneumonia Asthma Chronic Obstructive Pulmonary disease Small Group Learning Absolute cardiovascular risk Hypertension Coronary artery disease Small Group Learning Atrial fibrillation Chronic heart failure Cerebrovascular accident Small Group Learning Osteoporosis Metabolic syndrome and obesity Diabetes in your practice Thyroid disease Small Group Learning Venous thromboembolism Cancer screening - mammography, cervical screening Cancer screening - PSA / FOBT Small Group Learning SNAP Immunisations Catch up week EDUCATION WORKSHOP 2: RURAL GP Catch up week Small Group Learning 25 May 01 June 09 June 15 June 22 June 29 June 06 July 13 July 20 July 27 July 03 August 10 August 17 August 24 August 31 August 07 September 14 September 21 September 28 September 06 October 12 October 19 October 26 October 02 November 09 November 09 November 16 November 14

22 Direct observation by medical educators Within every 3 month period registrars will be observed consulting by a medical educator (a total of 5 for AGPT training - 2 in PRRT1/GPT1; 2 in PRRT2/GPT2 and 1 in PRRT3/GPT3). This involves an experienced GP or medical education registrar observing normal consultations over a 3 4 hour session. Feedback on aspects of the consultations will be given. Direct observations are arranged in advance at a time convenient to the medical educator, the registrar, the supervisor and the practice manager. It is preferred that 3 patients per hour are booked for the first 2 visits. Medical educators will also speak with the supervision team (supervisor, practice manager and practice nurse) to gain an overall impression of the registrar s competency. Following the observation, a report is compiled by the medical educator. This report highlights areas where the registrar has achieved the required level of competency. Additionally areas where further development by the registrar may be required are also recorded. The report is entered into QuickBase and can be accessed by the registrar, your supervisors and QRME staff. This report allows further tailoring of registrars learning plan and ongoing education. During registrar training they will be required to self-reflect on video-recorded consultations which will then be reviewed by a medical educator. ACRRM registrars will complete their formative mini-cex by direct observation. For further information click on this link to ACRRM assessment: Audit - Registrar Clinical Encounter All registrars are to participate in an audit. As clinical encounters are the core learning activity of general practice training in Australia the content of clinical experience should include common and significant conditions and be similar to that of a non-trainee (established) Australian GP. However, in real life, the curriculum walks through the door, and the exposure to different patient demographics and presentations can be highly variable between training posts and from one registrar to another. This can have an impact on the nature and quality of registrar training. The registrar clinical encounter audit aims to document and analyse general practice consultations in order to identify any curriculum gaps and learning needs. Data is recorded on QuickBase. What can be my snap-shot of a working week? This could be a Monday to Sunday period that you feel is indicative of usual work, or it could be Monday one week, Tuesday the next, Wednesday the next and so on. How many entries do I need to log? QRME will need to have a picture of clinical activity. Record the number of patients the registrar sees over this period. We fully expect that there will be variation in patient numbers, across days and across registrars. 15

23 What about when I work in a hospital, nursing home or elsewhere? All of the clinical work needs to be recognised for training. Logging work in settings other than private general practice is important. If a normal week includes hospital based time the registrar will be required to log the location and record patients seen. Do I record after-hours work? Registrars should record patients seen during after hours including calls you mange by telephone. Procedural log It is recommended that the registrars document procedures to assist in completion of a learning portfolio and in the identification of learning needs. This is a mandatory requirement for ACRRM registrars. The skills logbook can be found in electronic format on either RRMEO or QuickBase. Multi-Source Feedback and Professionalism Throughout practice based teaching registrars will be required to participate in multi-source feedback, CARE measure or similar patient and colleague questionnaires. The purpose of these questionnaires is to provide the registrar with feedback from patients, colleagues and peers on professionalism, empathy and other markers of therapeutic relationship within a consultation. They also show how you work collaboratively with practice staff and other members of the team. The CARE tool is a means of determining how well registrars are communicating with patients. The CARE tool questionnaire is completed by the patient after the consultation. This should be arranged with the practice manager or appropriate administrative staff. The CARE tool can be completed in either private general practice or in a rural hospital setting. The completed questionnaires are to be returned to QRME for collation. Feedback and information from the CARE tool is given to both the registrar and supervisor. Completion of this form of formative assessment is required to progress through the training program. Each registrar is required to have 50 questionnaires completed in both GPT1 and GPT3 or 4. Optional Tele-Internal Medicine Teaching The purpose of the service is to provide you with: general medicine consult (with medical educator and general physician Dr Spencer Toombes) teaching in general/internal medicine teaching and experience in telemedicine facilitation teaching and feedback on specialist referral processes This service is facilitated through the Toowoomba 7 Day Medical Centre which is equipped with telemedicine equipment that is compatible with most systems and formats including Skype. 16

24 It is preferred that you make a booking with a patient (which enables you to bill if >15km from Toowoomba 7 Day Medical) but otherwise the telemedicine link can be utilised for face to face discussion of a series of complex patients if that meets your learning objectives. Frequently asked questions regarding general medicine teaching are attached in Appendix 4. Optional Telederm Teaching It is very important that rural general practitioners develop extended skills in skin cancer medicine. The Telederm Program assists rural GP registrars in learning about skin cancer medicine and dermatology utilising teledermatology. It complements their rural training. Registrars have access to an adapted dermatoscope which allows them to utilise digital photography, enabling clinical photos that can be sent to a dermatology service for further advice. QRME use the teledermatology service provided by ACCRM (via RRMEO called Telederm). All patient cases are reviewed by Dr Jim Muir (Dermatologist) and Dr Benjamin Carew (a GP and dermatology registrar) and online advice is provided to the registrar within 48 hours. Within the Telederm website there is a facility that enables cases to be submitted which is only available for QRME registrars. This allows small group discussion on specific cases. Telederm has many useful resources (videos, Jim s tips, online cases, condition index and dermoscopy atlas) and can be used as a learning platform for skin cancer medicine and dermatology. A case-based monthly learning module is posted by Dr Carew, based on the ACRRM and RACGP dermatology curriculum, along with a pigmented lesion of the month. Out of Practice Teaching QRME registrars will attend either: 2 x 1week intensive residential workshops (for all registrars training in regions other than Toowoomba Region or Wide Bay Region) or monthly one day seminars (for registrars in Toowoomba Region or Wide Bay Region) Residential Workshop 1: GP Survival The workshop will be held from 2-6 February 2015 and is structured as an intensive educational workshop with other registrars commencing in general practice training. The topics cover introductory and essential skills for rural general practice. Registrars will complete (subject to change): An introduction to QRME and rural health Acute care in rural general practice and use of emergency doctor's bag in simulated scenarios (includes CPR). Mental health training (GPMHSC accredited MHST activity to access MBS Item 2715) GP essentials - consultation skills, and effective learning in general practice Musculoskeletal medicine 17

25 Residential Workshop 2: Rural General practice Workshop The second workshop will be held 9-13 November 2015 and covers such topics (subject to change) as: 1. Rural advanced life support and farm safety 2. Exam preparation 3. Teaching, mentoring and leadership in General practice 4. Challenging consultations 5. Cultural safety training 6. Palliative care, and 7. Sexual health 8. ENT For registrars completing the seminar program, seminars will be on the same topics. An up to date calendar of seminars can be found on: Monthly small group Every 4th week registrars meet for small group learning over 3 hours to discuss cases relating to a topic. Small groups will occur via WebEx unless alternative arrangements have been made. A link will be ed to the registrar prior to each small group session. During this small group the registrar will also be given specific tasks to complete each month e.g. prepare cases, questions, answer on-line dermatology quizzes. Exam preparation workshop In the first 6-12 months of training, our aim is to help registrars become good doctors. Teaching and learning in this time should be focused on the requirements of healthcare delivery to rural communities. During the following 12 months registrars will start to focus on specific exam preparation. QRME provides study material to help them prepare for exams (Facebook study group; study guide and practice questions). Details of ACRRM assessment can be found at: Details of RACGP Assessment can be found at: In the 6 month lead up to the summative assessments registrars are to attend small group learning focused on exam preparation. All registrars attend a practice OSCE or StAMPS workshop which aims to simulate the real exam. 18

26 Other Training Terms Registrars may choose from a range of extended skills that are relevant to individual training and career plans. Extended skills currently available are: General Practice, Aboriginal and Torres Strait Islander Health, Adult Internal Medicine, Mental Health, Academic General Practice (involving significant research and/or teaching components), Family Planning, Skin Cancer Medicine, Palliative Care, Expeditionary Medicine, Obstetrics & Gynaecology (DRANZCOG), Adolescent and Child Health, Anaesthetics and Emergency Medicine. The extended skill placement must be approved by your Training Advisor. Community based extended skill terms can only be undertaken after 6-12 months in general practice training whereas hospital based extended skill terms can be undertaken after the core hospital year. Advanced Specialised Training for ACRRM Registrars Advanced specialised training can be undertaken any time after core clinical training. Each AST has a separate curricula including assessment. Most ASTs occur over 12 months (exception Surgery 2 years). ASTs currently offered include: Aboriginal and Torres Strait Islander Health Adult internal medicine Anaesthesia Emergency medicine Mental health Obstetrics and gynaecology Population health Remote medicine Rural generalist surgery Paediatrics Academic training post (curriculum under development). ACCRM also require completion of: 2 ACRRM accredited emergency courses (QRME provides one of these courses during your normal training workshops) 4 RRMEO modules. Mandatory Elective Time For RACGP registrars, if they are granted Recognition of Prior Learning without time credit they must complete an equivalent number of Mandatory Elective units. Mandatory units can be taken in an area relevant to the registrars learning needs and must be applicable to rural general practice. Mandatory electives must be approved in advance by your Training Advisor. Completion of Training Extension (COT Extension) There is a delay between completion of registrar training requirements and being granted fellowship. During this time they can continue to work in an approved position and continue to bill Medicare. This time is called Completion of Training Extension (COT extension). 19

27 If a registrar has completed training requirements but has not sat or passed all College assessments they can apply for a COT Extension for Assessment by completing the appropriate AGPT form and by returning this to QRME. Optional Training Advanced Rural Skills Training RACGP registrars can consider further training by completing a year in an advanced rural skills training post. Training is completed according to the prescribed curriculum. The following disciplines are offered for ARST: Anaesthetics Obstetrics Surgery Emergency medicine Or non-procedural such as: Adult internal medicine Paediatrics Mental health Aboriginal and Torres Strait Islander Health Small Town Rural General Practice Other posts such as dermatology, sports medicine, sexual health will be considered after an application is made to the Rural Censor for approval. Conditions such as sufficient case load, adequate supervision and either a curriculum or detailed learning plan need to be met. FARGP A further option for FRACGP candidates is to pursue a Fellowship in Advanced Rural General Practice (FARGP). To be eligible for a FARGP registrars are required to work for a minimum of 12 months in a rural general practice setting that provides services including emergency/trauma services and after-hours at the local hospital or similar healthcare facility. The training post must have zero or limited local specialists. The FARGP has a separate curriculum which includes: Learning plan and reflection Completion of 2 EM courses (one provided by QRME) Completion of EM modules 6 month community based project. Research project If the registrar is interested in furthering a rural general practice research question, support is provided by the QRME Senior Research Officer who will assist the registrar with a rural GP research project. 20

28 Non-QRME educational events All registrars are encouraged to attend educational activities in their local region and external conferences. A copy of the attendance certificate should be kept as part of the registrars learning portfolio. Training Advisors (TA s) Registrars will be allocated a Medical Educator who will help guide them through training, monitor progress and assist where possible. Registrars must have contact with their Training Advisor at least once every 3 months. They are encouraged to keep in regular contact with their Training Advisor by or phone. The Training Advisor will discuss: Learning plan and recent achievements Formative assessment data that may have been collected New learning needs and how they may be met Personal and professional well being Career development and how that is progressing Review of administrative paperwork e.g. RPL, placement and leave forms Attendance at educational activities Exam enrolment and preparation Registrars can access their TA report on QuickBase. External Clinical Teaching (ECT) Visits Within every 3 month period registrars will have an ECT visit (a total of 5 for your GP training - 2 in PRRT1/GPT1; 2 in PRRT2/GPT2; and 1 in PRRT3/GPT3). An ECT Visit involves an experienced GP or medical education registrar. Following the ECT visit, a report is compiled by the ECT Visitor. This report highlights areas where registrars have achieved the required level of competency, and areas where further development may be required. The report is posted online and can be accessed by the registrar, your supervisor and QRME staff. This allows further tailoring of the registrar s learning plan and education. The 5th ECTV will occur remotely and a video recording of consultations will be assessed. Registrars are required to self reflect on these consultations before submitting the video recording for assessment. An ECT visit may also incorporate a Training Advisor consultation. For ACRRM registrars during an ECT visit registrars will complete a formative mini-cex. For more information click on this link to ACRRM assessment: Submit a general medicine case report Submit 5 KFP and 5 MCQ/AKT general medicine exam questions Frequently asked questions regarding general medicine teaching are attached in Appendix 4. 21

29 Communication Internet and are important tools that play an essential part in the delivery of QRME training and in general practice patient care. Registrars will need to develop sufficient computer and internet literacy. It is a requirement when training with QRME that a registrar has up-to-date computing facilities (i.e. hardware, operating system, reliable internet access and capacity to read PDF files). accounts should have a minimum of 4 Mb mailbox capacities to enable them to receive information from QRME and to avoid missing important QRME communications which may be blocked due to a mailbox full. Free services may not be adequate for these requirements. Many registrars comment that a password manager is a useful tool to keep track of the multiple passwords you will accumulate. QRME publishes an electronic newsletter to share news and information about QRME activities, events and achievements with our community of interest. All of the registrars training portals can be accessed via the QRME website at qrme.org.au At the top left of the QRME website, you will see a links to QuickBase and QRMe-online. QuickBase contains accreditation details, training terms for the current registrars and reports. QRME-online is where registrars access weekly learning modules (QRMe-learning); online resources such as Up-to-Date, Therapeutic Guidelines, BMJ; learning plan; workshop materials; and other learning activities and resources. Other useful links from includes links to the QRME Facebook, YouTube and Twitter. Financial Considerations QRME is a contracted training provider of AGPT. The AGPT program is administered and funded by the Commonwealth Government Department of Health. Under our contract, QRME receives funding to deliver training to registrars. As with all specialty training programs registrars are responsible for their own education and professional development. Registrars should expect to incur some expenses during training. Limited reimbursement of relocation expenses is available in some circumstances. Details and forms can be found on the QRME website under Forms & Templates. Training Post Placement QRME uses a 'best match' system to try and find the most suitable available registrars for you. The Practice Liaison Officer can discuss your preferences for a registrar. QRME then advises the registrar of the placement and asks they contact you for interview. If a best fit cannot be negotiated alternatives can be explored. RACGP requires that a registrar has placement at two separate training posts during their training time. ACRRM's policy is that you may be able to remain in one accredited training post for up to two (2) years of Primary Rural & Remote Training. Some posts (RA2) accredited with QRME have restrictions of 12 or 18 months for ACRRM training. 22

30 Part of the process in selecting a registrar is negotiating terms and conditions. The GPRA National Minimum Terms and Conditions provide information on minimum terms and conditions for registrar employment: During 2015 there will be a new version of the NMTC which will be known as GPRA National Terms and Conditions. It is likely that this will include new requirements which will impact upon employment agreements e.g. second year registrars to be employees. Once you have decided on a registrar you will need to complete the placement paperwork including confirmation of employment, have the supervisor sign the AGPT form (can also be known as a 3GA provider form) and Medicare application. Ensure you liaise with the registrar and keep a record of current placement dates to ensure that provider numbers (and associated access to Medicare benefits) do not expire. This primarily is the responsibility of the registrar. If the registrar works in more than one location separate placement paperwork is required. Overseas trained doctor are required to attach extra information with their applications. Please check with Medicare for these requirements. These forms must be submitted at least four weeks prior to the commencement date on the form (at least eight weeks for overseas trained doctors). Confirmation of Employment Registrars in training posts are required to complete an employer-employee confirmation of employment agreement. Both the registrar and the GP Supervisor are required to sign this document. QRME does not require a copy of your actual Employment Agreement. Hospital-Based Registrars Registrars completing core or advanced skill training in a hospital setting are required to provide QRME with a copy of their appointment letter from the hospital. Medical Indemnity Insurance Registrars are required to hold appropriate individual professional indemnity insurance, providing you with a copy at the commencement of the placement. Professional indemnity insurance costs are the registrar s responsibility and are not funded by QRME. Medical Registration Registrars are required to hold current medical registration at all times. It is their responsibility to ensure that registration is paid to AHPRA by the due date to avoid any lapse in registration as any training undertaken while not registered will not be recognised and will increase the length of time on the training program. All registration costs are the registrar s responsibility and are not funded by QRME. 23

31 Feedback and Program Evaluation QRME is committed to designing and delivering a program of the highest quality which aligns to the requirements outlined by RACGP, ACRRM and the Department of Health s Quality Assurance Accreditation Framework for Training Providers. Registrars, GP supervisors and practice managers are asked to commit to participating in an evaluation process, recognising that quality feedback will result in improvements to the education program and the processes which support it. The evaluation process includes: Feedback forms (via QuickBase to all GP supervisors and registrars at least twice each year) Seeking feedback on each workshop event at the time of delivery Seeking feedback gathered from individuals and small groups Seeking feedback from practice managers. Seeking feedback from registrars about the training post. Supporting the Registrar Commencing training post in a new location can be challenging for any doctor, but especially for a registrar relocating to a rural area. Many registrars also will be relocating their family which places additional pressures on them. Please consider how you and the staff can support the registrar e.g. bbq during the first week to introduce the family to some of the community. Financial Information QRME provides financial assistance to training sites towards costs associated with hosting and training a Registrar. The payments available are based on GPET National Guidelines with the level of support varying depending on the registrar term. See the QuickBase Manual for further information (Appendix 8). Training Post Subsidy GPT1/PRRT1 Term Full time Training post Subsidy for GPT1/PRR1 = $450 per week + GST. GPT2/PRRT2 Term Full-time Training post Subsidy for GPT2/PRR2 = $225 per week + GST. Teaching Allowances Teaching Allowances for Supervisors in GPT1/PRRT1 Term Full-time Teaching Allowance for GPT1/PRR1 = $150 per hour for 3 hours per week = $450 per week + GST. Teaching Allowances for Supervisors in GPT2/PRRT2 Term Full-time Teaching Allowance for GPT2/PRR2 = $150 per hour for 1.5 hours per week = $225 per week + GST. 24

32 For part-time registrar payments:- GPT1/PRRT1 Term 180 mins (3 hours) per week x 4 sessions 9 sessions per week = 80 mins. $ per hour x 80 mins 60 (1 hour) = $ GST per week. GPT2/PRRT2 Term 90 mins (1.5 hour) per week x 4 sessions 9 sessions per week = 40 mins. $ per hour x 40 mins 60 (1 hour) = $ GST per week. Professional Development for Managers QRME provides a seminar for managers at the end of each year which is normally held on the last weekend in November. This seminar and workshops provide useful tools and information that can assist in supporting a registrar. QRME encourages all of you to become a part of their training. Accreditation of Training Posts during 2015 During 2015 QRME will trial a new online accreditation process. This will be similar to the AGPAL or GPA plus accreditation online sites that you are already familiar with. The QRME accreditation area is found within QuickBase. The existing forms have been formatted as online forms - the required information remains the same. Additional information e.g. CVs, QICPD/PDP evidence are to be uploaded into the Accreditation area in QuickBase. Evaluation and feedback forms will be generated from QuickBase and sent to any post undergoing accreditation during Change to ASGC-RA system Senator Fiona Nash has announced the Federal Government will move to scrap the existing ASGC-RA scheme. This will be replaced by the Modified Monash Model which is an alternative classification model developed by Monash s Professor John Humphreys and colleagues. The MMM will add more realistic determinants of rurality into the classification mix, including population and access to services. The new classifications will be reflected in the incentive payment structure, making many small rural towns more competitive in attracting and retaining much needed doctors and going a long way towards getting the right doctors, with the right skills to the right places. District Workforce Shortage Changes to the DWS scheme will also make a significant difference in better supporting doctors and practices in small rural communities. The DWS is to be based on more recent data and the DWS status will be reviewed every 12 months rather than every 3 months with some flexibility available to each particular location to ensure DWS is more responsive to changes in the local workforce than has been in the past. 25

33 Intern training In order to have interns at your training post additioanl accreditation is required through the Post Medical Graduate Council of Queensland. For information: QRME Key dates 2015 Month Event Date(s) January MCQ & StAMPS enrolments close 27 January February AKT &KFP exam day 14 February March AKT results released 27 March MCQ assessment 28 March April KFP results released 23 April May StAMPS assessment May OSCE exam day 30 May June AKT, KFP & OSCE enrolments close 19 June July OSCE results released 03 July MCQ & StAMPS enrolments close 06 July August AKT & KFP exam day 01 August OSCE exam day 22 August September AKT results released 04 September MCQ assessment OSCE enrolments close OSCE results released 05 September 11 September 18 September October StAMPS assessment October OSCE exam day 23 October November OSCE exam day 08 November December OSCE results released 10 December 26

34 Orientation and Induction All registrars must undergo orientation and/or induction to the training post. This should be delivered by you, the practice nurse and GP supervisor. A general guide for orientation and induction follows. If you are an Aboriginal Medical Service or have a large number of indigenous patients, please ensure that you include cultural awareness/responsiveness in your orientation process. This would also include orientation for any registrar undertaking advanced skill terms in indigenous health. How Practice Managers and Staff Can Assist a Registrar You can assist the registrar in learning about general practice, particularly how your post runs and with aspects of management which will be new to him/her. You and your staff play a key role in the induction and orientation of a registrar. A tool has been developed to assist you with ensuring you have covered essential induction information regarding the teaching site (see the Placement Orientation Checklist at the end of this section). You or your staff can schedule the appropriate number of patients (2 initially per hour and then working up to a maximum of 4 patients per hour by the second year) by encouraging patients to see the new registrar, remaining sensitive to the registrars additional study requirements and educational activity time with the supervisor. When there is another doctor sitting in with the registrar or when consultations are being videotaped, it is beneficial to reduce the number of patient bookings for the registrar. Teaching time can sometimes be cancelled due to extra consultations or home visits. All staff have key roles to play in protecting this time and ensuring the teaching takes place. You should discuss with the supervisor when they plan to teach and schedule that time in the appointment book. Should a session be cancelled by the supervisor then either yourself or one of the nurses can utilise this session with the registrar. Be aware of communication from QRME, especially the QRME Newsletter Tips for Practice Managers Registrars are likely to feel some apprehension when commencing in a new training post. The following is a guide and should be used as a basis for planning the new registrar s induction and orientation. On the first morning, allow adequate time for the registrar to meet with you, nursing staff, administrative and other support staff. The afternoon should be set aside to enable the registrar to sit in with the supervisor to observe consultations and absorb the environment. Arrange a social event in the first week with doctors, staff and the registrar. Provide the registrar with guidelines on the community such as information on local schools, churches, local papers, maps, specialists and so forth. 27

35 Raise the awareness of the local community by organising an article in the local paper and displaying a photo with a brief introduction in the waiting room of the training post. Supply information on business structure, consulting room and clinic set up, referral processes, computer systems and programs, billing processes including policy and fees and receiving results. You can schedule an appropriate number of patients by encouraging patients to see the new doctor, remaining sensitive to the registrar s additional study requirements and educational activity time with the supervisor. Discuss with the doctors in the training post how many patients you should book per hour. As a guide, registrars at the start of their general training post experience are often only comfortable seeing about two patients per hour. Don t put pressure on registrars (especially GPT1/PRRT1) to handle all walk-ins. Educate other staff about the training program. Encourage patient feedback. Make sure the registrar is aware they can take tea and lunch breaks. Invite them to as many staff and management meetings as possible. Give them an insight into the ramifications of working in a rural town, for example, being approached by patients for advice in social situations. Most importantly, communicate. Ask what they may need help with and allow time for them to discuss problems with you. When there is another doctor sitting in with the registrar or when consultations are being videotaped, reduce the number of patient bookings for the GP Registrar. Registrars will have ECTVs during their training. You can assist with these visits by ensuring patients are aware and are happy to see the registrar that day. Consent will need to be given by the patient. All registrars are required to attend educational activities away from the training post. It is advisable to obtain the dates from the registrar for any external conferences etc. 28

36 Orientation / Induction General Checklist Prior to Commencement of the Registrar Prior to GP Registrar Commencement AGPT form signed by both supervisor and registrar, returned to QRME Medicare Additional Provider form signed and ed/faxed to QRME Confirmation of Employment signed by both supervisor and registrar, returned to QRME Organise name plate for consulting room Organise practitioner stamp Sign writing for front windows and/or training post nameplates Ensure stationary has been ordered (or template created in IT program) Named pathology forms to be ordered showing ID numbers PBS - RPBS Prescription Order Pad Make appointments for radiology and pathology liaison officers during first week Ensure appointment cards have been ordered Discuss appointment book with the supervisor Ensure dedicated protected teaching time is shown in both Registrar and Supervisor appointment books Ensure consulting room is clean and tidy, with equipment checked and stocked Contact GP Registrar and confirm starting date and time Confirm with the Registrar what day they will commence seeing patients Confirm Medicare provider number and prescriber number Personal Details Forms to be completed Tax File Number Declaration form Superannuation Form Salary Payment Form (registrar bank account details etc.). PAYG application After hours provider number (if at another site) Local hospital credentialling for the registrar for admitting rights Private health fund billing arrangements for hospital patients/vmo rights to local hospital if required 29

37 WorkCover service provider application Set up software and create passwords Place article in local paper advertising the arrival of the new registrar Organise Medicare Local membership Provider Registration for EFT payments (Medicare) Training post Incentives Program Service Incentive Payments banking details Application to Register as Immunisation Provider Bank Account Details for Immunisation Provider Application to Amend Health Care Provider Record Organise tour of local area with the supervisor for the registrar in the first week Send registrar induction package Organise a social meet and greet night for all staff and registrar (plus family) 30

38 An Orientation Package Guide Contents Map of the town area marked with the following: Public hospital Private hospital Nursing homes Pathology service Radiology service Ambulance Schools/day care etc. Real estate agents Emergency phone contacts for the training post After hours information sheet and phone numbers Allied healthcare phone numbers for your local area Allied Health Services wait list from local hospital List of all specialists, their specialty and phone numbers used by the training post List of shortcuts that perhaps is used in Best Practice etc. Frequently used phone numbers Flow chart for children with febrile illness Medicare Item number reference guide Emergency phone contacts for the training post Information sheet for local pathology services collection centres + maps Information sheet for local radiology services address and phone number, list of radiologists List of support services in the area e.g. Blue Care, Indigenous health etc. List of phone numbers for the local hospitals and nursing homes Information on your town or region so they can find suitable accommodation Information about schools in the area e.g. contact names and phone numbers Childhood immunisation chart 31

39 Registrars should be orientated to the training post suggested checklist as a guide Induction PM Reg Training post staff Introduce all staff Key people to ask for assistance Access to Training post Essential Community Contacts (including phone numbers) Allocate a key, alarm code and list the security firm details for the registrar (in case they work back and there is a problem) Pharmacist DEM Local Hospital Ambulance (including protocol on how to contact) After hours - supervisor and PM contact phone numbers List of local specialists, allied health professional and community resources. Medicare Local or PHN contacts Regional Contacts Domestic Violence Sexual Assault Child Abuse Mental Health Treatment/ Nurses/ Emergency Room Drug protocols Resuscitation equipment Adrenaline and adrenalin protocol ECG machine Spirometry Nebuliser Spacers Liquid Nitrogen Suture equip and local anaesthetic 32

40 Induction PM Reg Dressings, bandages, splints Plaster Sterilisation lay out where dirty equipment is placed Blood glucose monitor Oxygen and sucker Silver nitrate sticks Linen Consulting Room Equipment Speculum Pregnancy tests Proctoscopes Auroscope, ophthalmoscope Urine testing Sphygometer and different sized cuffs Tendon hammer and tuning forks Telephone how to use and extension numbers How to call for help Bodily fluid spills including blood and vomit (and vomit bags) Telehealth equipment (if delivered) 33

41 Pathology Blood taking equipment tubes, reference list for test ordering Swabs including all Chlamydia, HSV Urine (24 hour and paeds bags) and faecal containers Collection service Blood taking equipment tubes, reference list for test ordering Swabs including all Chlamydia, HSV Immunisation Australian Immunisation Schedule and Book/DVD (current version) Immunisation Schedule summary sheet (where they are kept and how to draw them up) Adrenaline and dosages Secure Areas Where to leave personal and valuable items S8 drugs safe protocols Drug samples Staff Facilities Tea room Drug rep days and timing Toilets Computers Clinical software Protocols and procedures for IT How to save documents internal and external Pathology results Management Policy and Procedure Manual Billing Emergency exits and protocols The unwritten rules how not to offend the training post staff 34

42 Appendix 1 - List of Acronyms ACRRM ACLS ADF AGPT AHPRA ALSO APLS ARST ASGC-RA AST CME DWS ECT/V EMST FACRRM FARGP FPQ FRACGP GPMHSC GPR GPRA GPS GPSN GPRIP GPT HLO IHT ME MHST MMM OSCE PBS PD PDP PHTLS PGY PRRT RACGP RRADO QI & CPD QHealth QRME QRMLP RAP RDAQ RGP RHTU RLO RPL RRMEO RVTS SLO SME TA VR Australian College of Rural & Remote Medicine Advanced Cardiovascular Life Support Australian Defence Force Australian General Practice Training Australian Health Practitioner Regulation Agency Advanced Life Support in Obstetrics Advanced Paediatric Life Support (course) Advanced Rural Skills Training Australian Standard Geographical Classification Remoteness Areas Advanced Specialised Training Continuing Medical Education District Workforce Shortage External Clinical Teacher/Visit Early Management of Severe Trauma (Course) Fellow of the Australian College of Rural and Remote Medicine Fellowship in Advanced Rural General Practice Family Planning Queensland Fellow of the Royal Australian College of General Practitioners General Practice Mental Health Standards Collaboration General Practice Registrar General Practice Registrars Australia General Practice Supervisor (now called Trainers by RACGP) General Practice Supervisor Network General Practice Rural Incentive Program General Practice Term Hospital Liaison Officer Indigenous Health Training Medical Educator Mental Health Skills Training Modified Monash Model Objective Structured Clinical Exam Pharmaceutical Benefits Scheme Professional Development Professional Development Program Pre-hospital Trauma Life Support (Course) Post-graduate year Primary Rural and Remote Training Royal Australian College of General Practitioners Registrar Research and Development Officer Quality Improvement and Continual Personal Development Queensland Health Queensland Rural Medical Education Queensland Rural Medical Longlook Program Reconciliation Action Plan Rural Doctors Association of Queensland Rural Generalist Program Rural Health Training Unit Registrar Liaison Officer Recognition of Prior Learning Rural and Remote Medical Education Online Remote Vocational Training Scheme Supervisor Liaison Officer Senior Medical Educator Training Advisor Vocational Registration 35

43 Appendix 2 Recognition of Prior Learning (RPL) All registrars are required to show evidence of satisfactory performance in hospital terms. Hospital term assessments are to be uploaded on to QuickBase. For registrars who have completed their 12 months of hospital time prior to joining AGPT you may be eligible for RPL. RPL takes two forms: RPL without time credit. This means that QRME recognise that registrars have satisfactorily completed mandatory hospital terms and 12 months of additional hospital/core clinical training and do not have to do additional hospital training time. Registrars are still required to complete the whole 3-4 years of GP training. RACGP registrars will NOT be eligible to sit the exam until after months on the program. RPL with time credit. If both the GP supervisor and training advisor recommend that a registrar is ready for independent training post earlier, an application may be made to a Senior Medical Educator and Director of Training (and subsequently college censors) to recognise hospital time as having occurred on the training program. This may shorten training time and may mean a registrar can sit examinations earlier. If are under a moratorium, RPL is likely to impact upon it. Full information on RPL is available at the college websites:

44 Appendix 3 - Learning plans All registrars are required to complete Learning Plans throughout their training. The Learning Plan is the key to a registrar s learning and reflects on areas of training post and their need of further skills development. The Plan assists the clinician to review gaps in their knowledge and to consider the necessary skills and understanding can be attained. GP Supervisors and Training Advisors play an important role identifying resources and providing support for the registrar. A learning plan pro-forma with examples for your consideration is presented over the next page. 37

45 What to learn The excision of simple skin lesions Why do you want to learn it? I am uncomfortable with my current level of skills in performing such procedures I have seen the results of poorly excised lesions in my patients When to learn it? (time frame and colour of urgency ) How to learn it? (be specific and concrete about exactly how you will learn) By end of GPT1 Research excision of lesions on gplearning website block out time with supervisor and receptionist for observing & practicing excisions ensure supervisor available to observe, get feedback from supervisor How will you demonstrate you have learned this? Feedback from GP supervisor, self confidence in excision follow up with patient log of post op complications pathology audit: % of complete excisions Curriculum area RACGP ACRRM DERT Dermatology Completed (date) The value of screening for prostate cancer I am unsure as to whether to offer screening Many of my patients request screening By end of month 4 in GPT1 Research evidence e.g. Andrology Australia, PubMed discuss with GP Supervisor at a training post teaching session discuss with a urologist their current training post I will compile a summary statement of the evidence and present this to patients requesting screening I will source and make available written resources to be given to patients MENT 2.6 MENT Population Health Urological Surgery The clinical examination of the shoulder joint I encounter frequent presentations of shoulder injury and am not confident in eliciting signs of rotator cuff damage By end of month 2 in GPT1 Review of online resources, e.g. YouTube discuss with and observe GP Supervisor performing such examinations spend a session with a local physiotherapist attend workshop session on joint examination Demonstrate examination succinctly to Supervisor and to physiotherapist Lead small group learning session on this subject to include practical demonstration of joint examination MSKLV Musculoskeletal Medicine, 5.4 Shoulder Conditions 38

46 Appendix 4 General medicine teaching a registrars perspective What is it? Booked telemedicine long consultations with a General Physician for you and your challenging or confusing medical patients. Who provides it? Dr Spencer Toombes is a specialist general physician based at the Toowoomba Hospital. He works one day a week as a medical educator for QRME, and provides this telemedicine service from the Toowoomba 7 Day Medical Centre, Neil Street, Toowoomba. Who is it for? All QRME registrars currently engaged in General Training post are invited to make use of this teaching and learning opportunity. Why are we doing it? To provide a general medicine consult service for your patients. To provide you with teaching and learning opportunities in general internal medicine. To provide you with experience and teaching in facilitating telemedicine. To provide you with experience and feedback regarding specialist referral process. What sort of patient should I choose? Choose a patient who you think would benefit from input from a general physician. These are often patients who have a complex problem or a complex collection of problems. Ideally choose a patient with the potential to fulfil your self-identified learning objectives. What data are we recording? The service provides a general physician consultation recording patient notes during the clinic, and sending you a summary letter including an agreed management plan afterwards. We will also ask you to fill out a very brief questionnaire before and after the consult - asking you to self evaluate how much you know about the particular patient problem, how confident you felt about their ongoing management, and to evaluate your experience of the telemedicine consultation. How do we bill? If your training post is more than 15km away from Toowoomba 7 Day Medical Centre, then we can bill both the consultant and facilitator ends as a Telehealth link: The relevant patient end item number is a 2143 "Level C telehealth facilitation in General Training post rooms". If your training post is within 15km of Toowoomba 7 Day Medical Centre, then we can't (and won't) bill for telehealth, but the facilitator will be able to bill a standard Level C GP attendance. How do I do it? You will need to: 1. Organise a booking Phone our receptionist at the Toowoomba 7 Day Medical Centre on Appointments are available on Thursday mornings. You will also need your training post to book at least a 45 min long consult for yourself with the patient - average complexity patients take about 30 minutes to review, allowing 15 minutes for discussion / teaching after the patient has left. This can be billed by your training post as a telemed consult. 39

47 2. Write a referral letter: Identify the question that you want answered by the consultation and summarise the patient's previous medical history, including an accurate list of medications and copies of their previous investigation results. This should be faxed to the Toowoomba 7 Day Medical Centre on Test (or get your training post manager to test) your telemedicine connection before your appointment. Many training posts are using Skype... which seems to be a reasonable option. In order to get a video connection, both your training post and our training post need to "Add" each other's Skype address as a Skype contact. We are using the Toowoomba 7 Day medical Skype account: tr1-7dmc Toowoomba 7 Day Medical Centre is equipped to connect to the majority of Telemedicine equipment and software. These devices will have either a phone number, or more usually a 12 digit IP address associated with them. What if I want to talk to a human instead of reading a FAQ? If you have any queries with the above, contact: Dr Spencer Toombes Office Hours phone: E: s.toombes@qrme.org.au The training post address for telehealth is: Toowoomba 7 Day Medical Centre Neil Street Toowoomba 4350 Phone: Fax:

48 Appendix 5 - Useful Apps, Resources and Study Links Instructions on how to add recommended apps and the following links: QRME Online Tap the QRME online icon to bring up the QRME online login page. Enter your login details. The QMRE e-learning modules & electronic therapeutic guidelines will be accessible via this site. Calendar 2014 Tap the Calendar 2014 icon to open the 2014 QRME Calendar. To add an event to your ipad calendar app, tap on it to open, and then tap the Add to Calendar icon. Tap save. Quickbase Tap the Sign in to Quickbase icon to bring up the QRME QuickBase login page. Enter your login details. Australian Medicines Handbook Tap the Australian Medicines Handbook Web-link to open the login page. You will need to have either a personal subscription or check if your practice has a business subscription to access the AMH. 41

49 Most registrars find a number of resources useful: Murtagh's General Training post (registrar given copy at first workshop) Therapeutic Guidelines and UpToDate - QRME provides registrars entering general training post training with access to these resources Royal Children's Hospital clinical training post guidelines ( RACGP guidelines (available free on-line at Family Planning Queensland - Patient information - ACRRM Clinical Guidelines for Mobile Devices Other websites Australian Doctor - Excellent How to Treat articles covering many common GP presentations. Medical Observer - A site with news summaries, education, guidelines and more. Very GP focused. 6minutes - A summarised daily news service. A quick read for catching up on current hot topics. RRMEO - The ACRRM online resource for education and training. Vast amount of materials, online learning and access to courses. Highly recommended, and a must for all FACRRM candidates. All QRME registrars have access to RRMEO. National Prescribing Service - Articles and education regarding common GP pharmacology. GP learning - An excellent resource for FRACGP candidates in particular. Many different topics covered, with applied knowledge questions (similar to the RACGP AKT exam). ThinkGP - An online, independent, RACGP & ACRRM accredited learning site. Most modules are supplied/prepared by RACP or a special interest group (e.g. Andrology Australia for men s health). Registration is free. Medicine Today - Another RACGP & ACRRM accredited learning site. Modules are based on articles from the journal, which is a very useful General Training post publication. Articles are available as PDFs online, and registration is free. Pri-MeD - Collaboration between UQ and Med-E-Serv to provide an RACGP accredited online learning site. Many common GP knowledge sets are addressed (e.g. palliative care, chronic kidney disease, antenatal care etc.). Registration is free. Australian Indigenous Health Info Net - Latest information on ATSI health. } Kimberley Aboriginal Medical Services Council - Evidence based protocols for ATSI health. 42

50 Appendix 6 QRME Contract with Registrars QRME Registrar requirements Complete the QRME program based upon the AGPT program including: Fulfil mandatory rotations Work in QRME accredited training sites Attendance and participation in training post teaching Attend all QRME education workshops and maintain annual CPR competency Complete QRMe-learning modules Prepare for and attend small group learning Complete a clinical audit/research project during Extended Skills/PRRT4 Participate in professionalism survey (e.g. MSF, CARE) Maintain an up to date learning plan on QuickBase Complete Aboriginal and Torres Strait Islander Health training Participate in Telehealth projects Complete general medicine teaching requirements Meet with your training advisor every 3 months and complete performance review Complete all other College requirements (either or both RACGP and ACRRM) Attend 2 Primary Health Network activities during training post-based training years Complete an elective offered by QRME during your training time Electives include (subject to change): Family Planning Teaching on the Run Procedural skills in rural training post Ultrasound Advanced cardiac life support and paediatric support Skin cancer medicine procedures Cultural competency Agricultural medicine Training post placements are arranged by QRME. A reasonable number of placement options will be made available. Placements will occur in locations RA2-5. Positions in RA2 cannot be guaranteed. QRME staff will arrange placement options for all registrars. Registrars are to only to contact training sites they have been referred to by QRME for possible employment and placement. Registrars are not to contact training posts without a referral. In most cases the registrar will need to undertake an interview with the training post before employment is agreed. 43

51 Appendix 7 - Requirements for Completion of Training RACGP Registrars Current general registration certificate Exam pass results letter from RACGP Fellowship application Any additional ALS/Emergency Course Certificates completed (Mandatory ALS provided as part of QRME workshop program) Any Extended Skills or educational certificates The registrar training record on QuickBase will need to demonstrate: Satisfactory fulfilment of contract arrangements as outlined in Contract for Registrars Completion of training interview organised by QRME ACRRM Registrars Application Form available from Record of Service for PGY 1 & 2 years (should have been uploaded prior to commencement of or during training) 3 x End of Term Assessments for Mandatory Rotations (should have been uploaded prior to commencement of or during training)supervisor Reports and if issued Certificates for AST At least 1 additional Tier 1 or 2 Tier 2 Emergency Course Certificates (One Tier 1 ALS provided as part of QRME workshop program) Logbook if in hardcopy Current General Registration Certificate Completion of training interview organised by QRME The training record on QuickBase will need to demonstrate: Satisfactory fulfilment of your contract arrangements as outlined in Contract for Registrars Completion of training interview organised by QRME 44

52 Appendix 8 - QRME Contacts for Managers TA = Training advisor ECTV = External clinical teacher visitor SGF = Small group facilitator AST = Advanced skill training Medical Education Team Name Key role in AGPT program Contact Professor Scott Kitchener (CEO and Medical Director) Overview of whole of training. Dispute resolution. TA for ADF registrars. E: s.kitchener@qrme.org.au M: Dr Kay Brumpton (Director of Training) Ensures your training is aligned with GPET and college policy, standards and curriculum. Remediation. Completion of training requirements. E: k.brumpton@qrme.org.au M: Key Support and Administration Name Mr Paul Purea (AGPT Manager/ATSI Health) Ms Kaitlyn Anderson (AGPT Administration Officer) Sunshine Coast, Wide Bay & CQ Mrs Lee Millis (AGPT Administration Officer) Toowoomba and South Burnett Contact p.purea@qme.org.au sunshinecoast@qrme.org.au widebay@qrme.org.au cq@qrme.org.au toowoomba@qrme.org.au sthburnett@qrme.org.au Mrs Joanne Green (AGPT Administration Officer) Brisbane, Southern and Western Regions Ms Bronwyn Chandler (Information Services Manager) brisbane@qrme.org.au southern@qrme.org.au western@qrme.org.au b.chandler@qrme.org.au

53 Name Mrs Amanda Ebzery (Information Services Officer) Ms Vicki Edwards (HR and Finance Administrator) Ms Pamela Elmes (Finance Manager/Board Support Officer) Contact

54 Appendix 8 - QuickBase Manual for Practice Managers Introduction This Manual has been developed to provide assistance for practice managers who are associated with accredited training sites for QRME registrars. It provides information relating to our database, QuickBase from basic functions to the submission of Activity Data Sheets for the provision of financial assistance to training posts towards costs associated with hosting and training a Registrar. Location The database is web-based and can be accessed via the URL: QuickBase can be accessed by most common web browsers and has a mobile interface for use on tablets and iphones. Access If you do not have access, please request access by contacting the QRME office on Only one login per training site is available. Password Creation Access is set-up with an invitation sent from our database administrator. When this is received, please follow instructions to create a password. The username will be your address. sent from qrme.org.au (via QuickBase) Click Green Link Open QRME Production Complete sign up process and create a security question/answer combination 47

55 You should now see the QuickBase My Apps page QuickBase My Apps This page contains all the QuickBase applications that you have access to. Choose QRME Production 48

56 Practice Manager Home Page The Practice Manager Home Page is your main page for accessing data. If you are able to, please bookmark this page. This page is made up of 2 main areas: Navigation Ribbon and Reports. Navigation Ribbon The Navigation Ribbon panel allows you to choose options: Activity Data Sheets Expense Claims Training Site Placement Requirements Practice Subsidy Invoices or Home Page. Activity Data Sheets Activity Data Sheets option lists all Activity Data Sheets submitted by you and allows the addition of new Activity Data Sheets. Expense Claims Expense Claims are not often used by you, but if attendance is required at a QRME workshop or similar, you may use this form for claiming reimbursement of costs incurred. The Expense Claims option in the Navigation Ribbon gives a list of expense claims submitted by you and the opportunity to add new ones. Training Site Placement Requirements Training Site Placement Requirements option lists all placement requirements submitted for your training site. New placement requirements or amendments can be made at any time. Practice Subsidy Invoices Practice Subsidy Invoices option lists all invoices generated by QRME. 49

57 Reports The My Registrars list is a report drawn from the training units being undertaken by registrars at a training site. It includes details about the training time and gives you an indication of how many reports have been submitted during the term: Supervisor Feedback Reports, Training Advisor Reports, Mini-CEX Reports, ECT Feedback Reports and Activity Data Sheets. Within the report is a button to add an Activity Data Sheet for the Training Unit Term for each registrar. The ECT Visit Report shows previous and scheduled visits for the registrar. Each report contains a link to Feedback provided by the ECT Visitor. Activity Data Sheets Activity Data Sheets should be submitted on a monthly basis. QRME Teaching payments are aligned with Weeks 4, 13 and 26 of the first two semesters e.g. GPT1/PRRT1 and GPT2/PRRT2. Part time registrars are calculated on a pro rata basis. Add Activity Data Sheet Go to You Home page View the My Registrars Report, if this is large, click on the Full Report option to load the report into its own page Locate the registrar for whom you wish to add the Activity data sheet Select the correct training unit term Click the Appropriate Add Activity Data Sheet button Entering Data The data fields for the online form have been taken from the paper version. If further clarification of the data fields is required, please advise QRME. Once all the relevant data has been entered by you save the form for the verification process to be completed. The form is shown as a table below. Training Details 1. Enter Registrar name 2. Select the appropriate Training Unit (this may require re-selection after the registrar is chosen) Activity data items Enter data into this editable table by double-clicking into the correct cell of the table. Data fields are as follows: Week commencing (always starts on a Monday and ends on a Sunday) (note: use the date picker to select the date) Consulting Time (Hours) Number of Patients A1 Medicare Rebateable Services (only those item numbers claimed through Medicare) 50

58 Non A1 Medicare Rebateable Services (items not been claimed through Medicare) QRME Workshops QRMe-Learning Hours Teaching Time (GP Structured Activities) Other Educational Activities (specify) Comments Total training hours Total hours Other Educational Activities Enter data into this editable table by double-clicking into the correct cell of the table. This information is an explanation of the Other Educational Activities mentioned in the Activity Data Item table. The total of these hours MUST add up to the amount listed in the Activity Data Item table, Other Educational Activities column. Data fields are as follows: Date From (Inclusive) Date To (Inclusive) Hours Details Registrar Leave Items 1. Enter data into this editable table by double-clicking into the correct cell of the table. 2. This table is for noting when the registrar has taken leave 3. Data fields are as follows: Date From (Inclusive) Date To (Inclusive) Leave Type Other specification. 51

59 Supervisor Leave Items 1. Enter data into this editable table by double-clicking into the correct cell of the table 2. This table is for noting when the supervisor has taken leave and who has taken over the registrar s supervision 3. Data fields are as follows: Date From (Inclusive) Date To (Inclusive) Name of replacement supervisor. Is the Sheet ready for Supervisor & Registrar to verify? Once the sheet is completed and ready for verification by Supervisor and Registrar, you should change the status to Yes and save the form. This will generate an to the Registrar and the Supervisor. Verification The Supervisor and Registrar must each login in their own right and verify the Activity Data Sheet. 52

60 Once the registrar /supervisor have logged into QuickBase, they must select Yes or No and save the form. When both parties are satisfied the data is accurate, i.e. both have responded Yes (see above) the Activity Data Sheet is ready for submission. Submission When the Activity Data Sheet is correct and ready for submission, you must change the status to Yes. This alerts QRME to pay the training hours and create an invoice. Invoicing QRME will generate a recipient tax invoices for all payments. Locate invoices Teaching Allowance Invoice To locate invoicing for each payment, view the My Activity Data Sheets report - ( Invoice files appear on the right hand side of the report. Practice Subsidy Invoice To view Practice Subsidy invoices, find the Practice Subsidy Invoices icon in the navigation ribbon and click it. 53

61 A report can then be viewed listing all Practice Subsidies paid Invoice files appear on the right hand side. Reports available My Registrars report This report displays all training units that have been allocated to registrars at the training site. It includes a summary of all reports submitted for the registrar during the training time and an Add Activity Data Sheet option. My Activity Data Sheets This report lists all the Activity Data Sheets submitted for the training site and includes all amounts paid by QRME. My Remediation, Incident or Complaint Report This report displays any Incident or Complaint you have submitted. My Expense Claims report This report displays all the expense claims that you have submitted. s Generated New Activity Data Sheet added confirmation Once an Activity Data Sheet is added, an is sent to you with a link to the Activity Data Sheet for future amendments, if required. 54