Registrar Handbook - Bogong GP Training
advertisement
2014 Registrar HANDBOOK Registrar Handbook 2014 This Handbook will be updated annually to reflect any policy, funding or educational based changes. Document Control Created Updated Updated 2 November 2010 November 2011 November 2013 D. Sweetland D. Sweetland D Sweetland BOGONG GP TRAINING Registrar Handbook 2014 Table of Contents Table of Contents ..................................................................................................................................................................3 CEO WELCOME MESSAGE......................................................................................................................................................5 STAFF AT BOGONG REGIONAL TRAINING NETWORK ............................................................................................................6 Chief Executive Officer ............................................................................................................................................6 Medical Education Team .........................................................................................................................................6 Administration Team ...............................................................................................................................................7 Communications Skills Tutors ..................................................................................................................................8 BOGONG REGIONAL TRAINING NETWORK OFFICES ..............................................................................................................8 BOARD MEMBERS..................................................................................................................................................................9 LEARNING ............................................................................................................................................................................10 CHOOSING A PATHWAY .......................................................................................................................................................11 Training towards Fellowship of Royal Australasian College of General Practitioners (RACGP).............................11 Training towards Fellowship of Australian College of Rural and Remote Medicine (ACRRM) ..............................11 Training towards Fellowship in Advanced Rural GP (FARGP) ................................................................................11 Timelines for the three (3) pathways ....................................................................................................................12 FRACGP and ACRRM Vocational Training – a comparative table ..........................................................................13 UNITS OF TRAINING .............................................................................................................................................................14 TERMS ..................................................................................................................................................................................14 Hospital-based Registrars (RACGP or ACRRM) ......................................................................................................14 GPT1/ GPT2 (RACGP) or PRR1/ PRR2 (ACRRM) Registrars ....................................................................................15 Practice-based learning .........................................................................................................................................15 Workshop-based learning .....................................................................................................................................15 Bogong Learning Tasks ..........................................................................................................................................15 Self-directed learning ............................................................................................................................................15 AVAILABLE POSTS ................................................................................................................................................................16 Hospital terms (H Units) ........................................................................................................................................16 Mandatory Hospital rotations ...............................................................................................................................16 GPT1 - 4 and PRR1 – 4 (General Practice or Rural Training) ..................................................................................17 Extended Skills Posts (ES Units) .............................................................................................................................17 Advanced Rural Skills Training (ARST) ...................................................................................................................17 Academic General Practice posts ..........................................................................................................................17 BOGONG MANDATORY REQUIREMENTS ............................................................................................................................18 EXAMS/ASSESSMENTS .........................................................................................................................................................19 Formative Assessment – RTP level ........................................................................................................................19 ACRRM Summative Assessment ............................................................................................................................19 RACGP Summative Assessment .............................................................................................................................19 EXTENSION OF TRAINING TIME ...........................................................................................................................................20 GPRIME (Bogong’s On-Line Learning Platform) .................................................................................................................20 OVERSEAS TRAINED DOCTORS (OTDs) ................................................................................................................................21 What is a 10 year moratorium? .............................................................................................................................21 Exemption to the 10 year moratorium? ................................................................................................................21 Moratorium scaling ...............................................................................................................................................21 New Zealand Doctors ............................................................................................................................................21 WHAT TO DO PRIOR TO COMMENCING A GP TERM ...........................................................................................................22 Registrar to provide to Practice .............................................................................................................................22 How to acquire provider and prescriber numbers ................................................................................................22 BOGONG GP TRAINING 3 Registrar Handbook 2014 Application for Recognition as a General Practitioner Form .................................................................................23 Application for Medicare Provider Number ..........................................................................................................23 Application for Medicare Prescriber Number .......................................................................................................23 Provider Numbers after Award of Fellowship .......................................................................................................23 Other tasks prior to commencing term .................................................................................................................24 EMERGENCY MEDICINE COURSE .........................................................................................................................................24 RECOGNITION OF PRIOR LEARNING ....................................................................................................................................25 Recognition of prior learning with time credit (RPL) .............................................................................................25 Recognition of prior learning without time credit (RC) .........................................................................................25 GP REGISTRAR PAYMENT & ASSISTANCE PACKAGE ............................................................................................................26 Emergency Medicine Course (REST) ......................................................................................................................26 OTHER GRANTS AND SUBSIDIES ..........................................................................................................................................27 General Practice Rural Incentive Program (GPRIP)................................................................................................27 Rural Procedural Grants Program ..........................................................................................................................27 HECS Reimbursement Scheme ..............................................................................................................................27 Department of Human Services (DHS) – Continuing Professional Development (CPD) for Rural GPs Subsidy Program .................................................................................................................................................................27 EMPLOYMENT INFORMATION .............................................................................................................................................28 Guidelines for Leave ..............................................................................................................................................28 Parental Leave .......................................................................................................................................................28 Employment arrangements ...................................................................................................................................28 SUPPORT STAFF ...................................................................................................................................................................29 Registrar Liaison Officer (RLO) ...............................................................................................................................29 Registrar Board Member .......................................................................................................................................29 Training Advisor (TA) .............................................................................................................................................29 Medical Educators (ME) ........................................................................................................................................29 External Clinical Teaching Visitors (ECTV) ..............................................................................................................29 Direct Observations (or video) ..............................................................................................................................30 GP Supervisors .......................................................................................................................................................30 GP Supervisor Liaison Officer (SLO) .......................................................................................................................30 Registrar Assistance Program ................................................................................................................................30 COMPLAINTS AND GRIEVANCES ..........................................................................................................................................31 USEFUL RESOURCES.............................................................................................................................................................32 Recommended texts for General Practice .............................................................................................................32 Registrar Practice Pack ..........................................................................................................................................33 WHOM TO RING AT BOGONG REGIONAL TRAINING NETWORK .........................................................................................34 APPENDICES .........................................................................................................................................................................35 Acronyms ...............................................................................................................................................................36 Things to do in the Region .....................................................................................................................................37 Organisations – State and National .......................................................................................................................38 Organisations – Regional .......................................................................................................................................39 GPRIP Fact Sheet ...................................................................................................................................................40 Privacy Policy – Bogong Regional Training Network .............................................................................................43 Bogong Learning Task (BLT) ...................................................................................................................................45 Registrar Handbook – Sign off sheet .....................................................................................................................48 4 BOGONG GP TRAINING Registrar Handbook 2014 CEO WELCOME MESSAGE Dear Registrar, Congratulations on choosing a career in General Practice and welcome to Bogong Regional Training Network – home to Mt Bogong, Victoria’s highest mountain, and, we like to consider; the pinnacle of GP training! We are one of the 17 Australian training providers and the Bogong region covers the North East of Victoria, the Border region of NSW/Victoria and the Goulburn Valley. This region is noted for its natural beauty, thriving regional centres and prosperous small rural townships; consequently our 47 accredited teaching practices offer our registrars diversity of experience in General Practice and primary health care, including many opportunities to learn and practice procedural and extended skills. One of our great strengths is the high quality of our education and training program for registrars. This is based on two key facets: the in-practice teaching curriculum whereby your primary and secondary supervisors are committed to both formal and informal teaching opportunities; and the structured Peer Learning Workshops’ (PLW) delivered by our experienced team of medical educators. These PLWs have evolved to be a keystone of Bogong’s success – as a registrar you are learning with a constant cohort of peers, enabling you to share your learnings, support each other and develop collegiate networks which will remain throughout your career. Each of you will be individually supported by a training advisor, one of our GP medical education team, who is there to give you individual support, coaching and mentoring during your entire training time with Bogong. In addition our Registrar Liaison Officer is able to assist in ensuring that any problems you encounter can be aired and resolved, and that registrar voices can be heard as we continuously improve our training provision. As a Bogong registrar you will also be well supported by a skilled administrative team in our head office in Wodonga. Here you will find information about the delivery, evaluation and administration of the Program and details of our teaching practices. At Bogong we like to think that our GP Registrars view their training as the start of an exciting journey building a successful and rewarding career as a General Practitioner and serving the needs of the Australian community. It is our role and our privilege to help you acquire new skills, help you question and help you develop your own learning style in this journey of lifelong learning. Enjoy the journey! BOGONG GP TRAINING 5 Registrar Handbook 2014 STAFF AT BOGONG REGIONAL TRAINING NETWORK Chief Executive Officer Ms Linda Moon lmoon@bogong.org.au Medical Education Team Dr Kate Davey Director of Training kated@bogong.org.au Dr Mark Burgemeister markb@bogong.org.au Dr Peter Keppel pkeppel@bogong.org.au Dr Russell Richardson rrichardson@bogong.org.au Dr Carolyn DePoi cdepoi@bogong.org.au Dr Ursula Read uread@bogong.org.au Dr Wendy Connor wconnor@bogong.org.au Hubert van Doorn hvandoorn@bogong.org.au Jenny Vibert jvibert@bogong.org.au 6 BOGONG GP TRAINING Registrar Handbook 2014 Administration Team Deanne Sweetland Robyn Matthews Operations & Training Manager Finance & Business Manager rmatthews@bogong.org. au dsweetland@bogong.org.au Jo Hamilton Isabelle Swanson Skills Training & Accreditation Administrator Education Program Coordinator jhamilton@bogong.org.au iswanson@bogong.org.au Jenna Peerman Sue Porter Administration Assistant Executive Assistant jpeerman@bogong.org.au sporter@bogong.org.au Robyn Bottrell Jane Delaney Finance Officer Training Administration accounts@bogong.org.au jdelaney@bogong.org.au Mary-Anne Scully Karen Dixon Marketing & Communications Officer Program Development mscully@bogong.org.au kdixon@bogong.org.au Peter Wyman Dr Erwin Wong IMG Program Coordinator Registrar Liaison Officer pwyman@gvgp.com.au freshclay@hotmail.com BOGONG GP TRAINING Manager 7 Registrar Handbook 2014 Communications Skills Tutors Bogong has a professional cohort of Language, Communication and consultation Skills’ Tutors who assist overseas trained doctors (OTDs) to adapt and gain competency in the consultation skills process vital to the practice of medicine in Australia. Written, spoken and comprehension language problems are also addressed and Dr Terri McNally, a retired GP, leads the Tutor Group in a Consultation Skills’ Consultant capacity to deliver comprehensive communication support to overseas trained doctors. Our Tutors are involved in the Registrar and OTD Workshops held throughout the year, taking part in role plays, communication assessments and written referral education sessions. Please do not hesitate to contact Bogong if you would like assistance in these areas. Terri McNally Robyn Reynolds Susan Jerie Judy Beaumaris Jann Stewart Retired GP Bogong Region Benalla, Cobram, Seymour Wangaratta Albury, Wodonga, Shepparton Corowa, Myrtleford Joy Phillips Barb Trainor Albury, Wodonga, Beechworth, OTDNet Wangaratta Wangaratta, Wodonga, Benalla BOGONG REGIONAL TRAINING NETWORK OFFICES Head Office Address: Postal: Email: Phone: Fax: Hours of operation: Website: Level 4, 111-113 Hume St, Wodonga VIC 3689 PO Box 165 Wodonga VIC 3689 bogong@bogong.org.au 02 6057 8600 02 6024 7817 9am to 5pm, Monday to Friday http://www.bogong.org.au Shepparton Office – Goulburn Valley Medicare Local Contact: Address: Phone: Fax: 8 Peter Wyman – IMG Program Coordinator 226 Wyndham St, Shepparton VIC 3632 03 5831 5399 03 5831 5398 BOGONG GP TRAINING Registrar Handbook 2014 BOARD MEMBERS Dr Graeme Jones (Chair) Dr Phil Steele Lister House Federation Clinic Shepparton Wodonga (03) 5831 2333 (02) 6059 2500 Dr David Kelly Dr Tess Goodwin Euroa Medical Family Practice Central Medical Group Euroa Wodonga (03) 5795 2011 (02) 6024 3233 Dr Graham Slaney Dr Matt Byrne Mansfield Medical Clinic Ovens Medical Group Mansfield Wangaratta (03) 5775 2166 (03) 5721 2176 Dr Angela Stratton Dr Alison Green Mt Beauty Medical Centre Central Medical Group Mt Beauty Wodonga (03) 5754 4003 (02) 6024 3233 Dr Michael Bartram Dr John Elcock The Doctors of Lavington North East Health Albury Wangaratta (02) 6057 7100 (03) 5722 0260 Ms Georgia von Guttner University of Melbourne Rural Clinical School Shepparton (03) 5823 4500 BOGONG GP TRAINING 9 Registrar Handbook 2014 THE REGION Bogong Regional Training Network (Bogong) provides vocational education and training for general practice in North Eastern Victoria and Southern New South Wales. It incorporates areas serviced by the Hume and Goulburn Valley Medicare Locals. It incorporates 47 general practice based training sites, three (3) regional hospitals and several small district hospitals. A full list of training sites can be found on the Bogong website: http://www.bogong.org.au. All listed training posts in the Bogong regions are accredited against the current RACGP and ACRRM Standards for Trainers and Training posts. LEARNING Bogong’s Vision is a community of competent and confident GPs who at all stages of learning, are wellsupported, satisfied and leading high quality general practice for improved community health. Bogong is committed to providing ‘best practice’ General Practice education and training experience, delivered locally by well-supported rural and regional general practitioners. Learning within our training program is locally-based, regionally responsive and adaptable to individual needs. We are able to provide a variety of learning resources in a number of formats at different stages of training. (see page 15) Our registrars are now able to enrol in both the RACGP (Royal Australian College General Practitioners) and ACRRM (Australian College of Rural and Remote Medicine) curriculum. These curricula cover several ‘Domains’ of academic content, details of which will be made available to each new program participant. 10 BOGONG GP TRAINING Registrar Handbook 2014 CHOOSING A PATHWAY Training towards Fellowship of Royal Australasian College of General Practitioners (RACGP) Bogong provides a comprehensive high quality training program compliant with the requirements of the RACGP curriculum. The RACGP pathway is a three (3) year program which includes an initial hospital year and two (2) years of community based general practice. Six (6) months of this training could be undertaken as an extended skills term in an area of interest. During this period, Bogong will run peer learning workshops as well as work closely with GP Supervisors to ensure all GP registrars receive appropriate experience, adequate teaching and mentoring. Training towards Fellowship of Australian College of Rural and Remote Medicine (ACRRM) Bogong is fortunate to be able to provide high quality training in rural and remote medicine. Many of our supervisors and medical educators have a high-level of experience in providing extended generalist care in relatively isolated settings. Many provide procedural services particularly in the fields of anaesthetics, obstetrics and emergency medicine, often the domain of specialists in urban settings. Bogong is able to offer registrars unique training opportunities in these fields and other areas relevant to rural practice. Training for a fellowship in ACRRM includes a four (4) year program. In some circumstances, this time period can be reduced through the recognition of prior learning (RPL) which must be formally approved. Extra mandatory modules and activities will be required in addition to the standard workshops provided when undertaking this pathway. Registrars wishing to undertake this pathway will need to make their decision early in their first year of the training program. For more information, please phone ACRRM on freecall 1800 223 226 or go to the ACRRM website at www.acrrm.org.au. Please speak to your training advisor early if you are interested in this pathway. Training towards Fellowship in Advanced Rural GP (FARGP) The FARGP pathway is an additional non vocational qualification that can be added to the three (3) year RACGP pathway. It involves an additional year of training undertaking an Advanced Rural Skills Training post (ARST) including mandatory learning modules and educational activities. Registrars interested in training towards the FARGP are advised to discuss this with their training advisor at the earliest opportunity. You must decide by 31 July in your first year of general practice, which training pathway you will undertake – FRACGP ACRRM RACGP/ACRRM (dual pathway) You must decide by 31 July of your second year of general practice, if you wish to train towards a FARGP BOGONG GP TRAINING 11 Registrar Handbook 2014 Timelines for the three (3) pathways YEAR 1 YEAR 2 RACGP FARGP ACRRM Hospital Training Hospital Training Core Clinical Training (RPL available) (RPL available) (RPL available) 26 weeks GPT 1 (Semester 1) GPT 1 (Semester 1) 26 weeks GPT 2 (Semester 2) GPT 2 (Semester 2) 52 weeks Primary Rural and Remote training PRR1 to 4 26 weeks GPT 3 (Semester 3) GPT 3 (Semester 3) 26 weeks GPT 4 (Semester 4) Extended Skills GPT 4 (Semester 4) Extended Skills YEAR 3 EXAMS: - AKT - KFP - OSCE ASSESSMENT FRACGP completed YEAR 4 ASSESSMENT 12 (RPL available) 52 weeks FRACGP attained Advanced Rural Skills Training post Advanced Specialised Training Skills Post Learning Portfolio Completed and submitted Four RRMEO modules Anaesthesia rotation O&G rotation Exams (MSF, Mini CEX, MCQ, StAMPS) FARGP completed FACRRM completed BOGONG GP TRAINING Registrar Handbook 2014 FRACGP and ACRRM Vocational Training – a comparative table AGPT Statement Training can commence AGPT Selection Status of qualification Endpoint of training Membership requirements Education framework Training model Training delivery and support Length of training Core training Core training Focus – skills training term Requirements – skills training term Equivalence in skills training Training flexibility – order of completion Training locations RACGP vocational training Post PGY2 (after intern year plus one additional hospital year, which can be undertaken before or after enrolment in AGPT) Required to commence training During or post PGY2 FRACGP – recognised vocational training qualification Vocational recognition (VR) Required for examination purposes College-based curriculum and standards Apprenticeship training model RTP/supervisor delivered training and support, with specific additional support from college offered to Registrars Three year training program of which 18 months must be in an approved ‘general practice’ setting GPT1 + GPT2 + GPT3 18 months – completed over 3 semesters each of 6 months Extended skills training (focus: general practice) 6 months – can be done in either an approved community based general practice or in an approved hospital training post Advanced specialised training may be recognised for extended skills training purposes in some circumstances - Some flexibility - Extended skills (hospital) – before/during/after core training - Extended skills (community) – after GPT1-3 completed. RRMAs 1 – 7 subject to moratorium requirements FACRRM – recognised vocational training qualification Vocational recognition (VR) Required to commence training College-based curriculum and standards Apprenticeship training model RTP/supervisor/college (via RRMEO) training and support offered to Registrars Assessment College examinations Part-time training Part-time available (minimum 3 sessions per week for time to count towards training). Limited RPL for recognition of equivalent hospital training time and extended skills RPL Additional training options BOGONG GP TRAINING ACRRM vocational training Registrars can undertake an additional fourth year of rural-orientated training to gain the FARGP qualification Required to commence training Four year training program occurring predominately in rural and remote settings Primary rural and remote training 24 months – completed over 4 semesters each of 6 months Advanced specialist training (AST) (focusrural generalist) 12 months – can be done in either an approved community based general practice or an approved hospital training post Extended skills training may be recognised for advanced specialised training purposes in some circumstances Fully flexible – no required order (core hospital training must be completed first) RRMAs 4-7. Components of training e.g. core and AST may be done in RRMAs 1-3 depending upon specialised skills chosen Formative and summative assessment tasks throughout training Part-time training available (minimum 3 sessions per week for time to count towards training). RPL available – for all stages of training There are no additional options. FACRRM is a four-year inclusive program 13 Registrar Handbook 2014 UNITS OF TRAINING A Unit is defined as a block of 13 weeks of full-time training. A Term is defined as 26 weeks (six months) of full-time training. Completion of training for FRACGP requires 12 units which are made up of: Hospital training – H units 4 units GPT1 Term 2 units GPT2 Term 2 units GPT3 Term 2 units Extended Skills training – ES or GPT4 term 2 units A Registrar may undertake a further year of training – an Advanced Rural Skills Training post (ARST) TERMS Hospital-based Registrars (RACGP or ACRRM) GP Registrars may be working in the hospital setting at a variety of stages throughout training. New registrars will be undergoing H units; while more experienced registrars may be in ES Units or ARST (Advanced Rural Skills Training) posts, detailed later in this handbook. All hospital-based registrars will take part in regular meetings via teleconference with the BRTN appointed medical educator, providing an opportunity to discuss both educational and personal support issues. Education sessions specifically for hospital-based registrars are arranged via teleconference, to allow for distance registrars and difficult rosters. These are facilitated by Bogong Medical Educators and GP Supervisors and reflect topics relevant to general practice. See pg 16 for mandatory hospital rotations 14 BOGONG GP TRAINING Registrar Handbook 2014 GPT1/ GPT2 (RACGP) or PRR1/ PRR2 (ACRRM) Registrars In the GPT1/PRR1 and GPT2/PRR2 terms of the training program, participants will be assisted in developing learning plans. Learning will occur via four major activities during this time. This includes practice based learning, workshop based learning, Bogong Learning Tasks (BLTs) and self-directed learning. Practice-based learning As GP Training in Australia is based on an apprenticeship model, most of the learning happens within the teaching practice, with the assistance and direction of the GP Supervisor. Registrars will have the opportunity to have their patient consultations observed and critically appraised and will undertake practicebased learning, guided by their nominated supervisors and/or senior colleagues. Teaching practices have documented teaching plans, outlining the styles and methods of teaching and learning commonly used in the practice. GP Supervisors form part of an active network and continue to learn skills of teaching in their practices. It is mandatory during first and second terms to satisfactorily engage in practice based learning, undergo direct observation or video by your supervisor and have external clinical teaching visits (ECTV) from experienced GPs from outside of your practice. Workshop-based learning Medical Educators will provide the core of the workshop-based education according to our established educational plan. Ten workshops are planned, spreading across the GPT1/PRR1 and GPT2/PRR2 terms. These workshops, conducted in various locations around the region, involve a series of education sessions based around a broad topic. The program is flexible however, and registrar feedback and input is actively sought. Far from being a series of lectures, these sessions are based on adult-learning principles and focus on case discussion and small-group activities. Time is set aside for debriefing and discussing any current concerns or problems. There is also an opportunity for registrars to present topics to their colleagues, particularly with the Bogong Learning Tasks. Attendance at all workshops is mandatory and if missed must be repeated Bogong Learning Tasks A useful educational skill for GPs is to be able to research a topic and present to a group of colleagues. The Bogong Learning Task (BLT) requires GP Registrars to research and present a topic allocated early in the term. The focus should be on experiential learning and reporting back to peers. Topics will link with themes of the education workshops. GP supervisors will assist with resources and suggestions for the presentation. The report should demonstrate the use of the acquired presentation skills using visual aids. Reporting should include things that were learnt and how they will affect their work in General Practice. (see Appendix pg 45) This is a mandatory activity within BRTN Self-directed learning Self-directed learning is an important part of ongoing learning in general practice. Registrars are expected to read widely, and seek further learning using a variety of learning resources. Medical Educators and GP Supervisors can assist with directing to appropriate resources. BOGONG GP TRAINING 15 Registrar Handbook 2014 AVAILABLE POSTS Hospital terms (H Units) Hospital terms are negotiated directly with the employing hospital. However, as there are some requirements for these terms for GP Registrars, please discuss your proposed terms with your training advisor. Hospital terms within the region are available at: Northeast Health - Wangaratta Goulburn Valley Health – Shepparton Albury/Wodonga Health – Albury and Wodonga campuses All hospital terms require you to get your hospital supervisor to complete a report for each 13 week rotation on your progress during the term. Mandatory Hospital rotations These include: Paediatrics General Medicine Emergency General Surgery Plus at least three of the following (or similar): Accident and Emergency Anaesthetics Dermatology Ear, Nose & Throat Geriatrics Infectious Diseases Oncology & Gynaecology Opthalmology PGPPP Psychiatry Rehabilitation Urology ACRRM Candidates must also include: Anaesthetics 16 Obstetrics & Gynaecology BOGONG GP TRAINING Registrar Handbook 2014 GPT1 - 4 and PRR1 – 4 (General Practice or Rural Training) These terms must be completed in RACGP/ACRRM accredited teaching practices. A current list of practices can be found on the Bogong website. Extended Skills Posts (ES Units) A range of Extended Skills Posts are on offer including: Aboriginal Health Alpine Sports Medicine Obstetrics & Gynaecology (Basic) Emergency Advanced Rural Skills Training (ARST) The following Advanced Rural Skills Training posts are offered through BRTN: Aboriginal Health Anaesthetics Mental Health Obstetrics & Gynaecology (DRANZCOG Advanced) Small Town General Practice Emergency Bogong Regional training Network requires Expressions of Interest in the above positions by June of the year preceding the year that you wish to undertake the post. Academic General Practice posts Bogong is associated with 2 local University campuses. Advanced Academic Rural GP posts are available at both the University of Melbourne’s Department of Rural Health based in Shepparton and the UNSW School of Rural Health In Albury. Opportunities exist to become an Academic Registrar within the training program. If you have an interest in this area, please contact the Bogong office and speak to your Training Advisor. Further information can be located on the GPET website www.gpet.com.au. BOGONG GP TRAINING 17 Registrar Handbook 2014 BOGONG MANDATORY REQUIREMENTS General Practice Term 1 & 2 (GPT1/PRR1 & GPT2/PRR2) Creation and continued use of learning plan on GPRime electronic platform (see pg 20) 100 % attendance at Peer Learning Workshops (PLW) Bogong Learning Task (BLT) Direct Observation/video by your Supervisor (2 per term) ‘Training Advisor’ meetings (1 per term) External Clinical Teaching Visit (ECTV) by visiting GP (2 per term) Procedural Log Book – to be used for any off-site procedures sign off (ACRRM only) Registrar Semester Feedback Report on Practice-end of term General Practice Term 3 & 4 (GPT3/PRR3 & GPT4/PRR4) Attendance at 2 registrar workshops ‘Training Advisor’ meetings (1 per term) External Clinical Teaching Visit by visiting GP (1 in term 3) Procedural Log Book – to be used for any off-site procedures sign off for ACRRM Registrars Diversity of Practice placement and essay Diversity of Practice Experience (RACGP Ruling) All Registrars must have experience in more than one Practice during their training time. This can be achieved by working 26 FTE days in another practice, preferably in a block form. Many practices already have agreements in place to swap GP Registrars to fulfil this requirement. There will be an expectation that you complete a short essay of your experience and how it relates to the domains of general practice. This will need to be submitted at the end of your diversity. A form is available for download on GPRIME. Practice Placement Rulings All GPT1-2 and PRR1-2 placements are made through the Bogong Practice Match policy and procedure. Registrars then sign a 12 month contract as an employee with a Practice. 18 BOGONG GP TRAINING Registrar Handbook 2014 EXAMS/ASSESSMENTS Eligibility to sit the appropriate College exams is not an automatic process. Each College has specific requirements about time and core content completion that must be undertaken prior to enrolling for the exams. The information about these requirements can be found on the respective College websites. http://www.racgp.org.au/education/fellowship/exams/exam-enrolments/ http://www.acrrm.org.au/operational-policies Please discuss with your Training Advisor your readiness to sit exams. Registrars will be expected to sit their FRACGP exams in their GPT3 term. . Formative Assessment – RTP level Regular monitoring throughout training Registrar self identification of learning needs e.g. Communication Support Supervisor feedback and review (ECT & Direct observations) Medical Educator monitoring, feedback and review Identify learning needs early and implement targeted support to assist as necessary Extra training support can only occur prior to completion of mandatory training time not during extension of time The AIM – competent, successful and self sustaining GPs ACRRM Summative Assessment Clinical Skills Logbook – progressively completed Summative MSF – Anytime after 24 months of completed training Summative MiniCEX – Anytime after 24 months of completed training MCQ – Anytime after 12 months of completed training StAMPS –normally undertaken when all the above have been completed Learning Portfolio RACGP Summative Assessment Completed 3 years of accredited training Completed 3 years of Bogong mandatory requirements Successfully complete the three (3) part exam which includes: AKT – Applied Knowledge Test KFP – Key Features Problems OSCE – Clinical Exam Exams can be undertaken sequentially but must pass AKT before being able to sit the OSCE BOGONG GP TRAINING 19 Registrar Handbook 2014 EXTENSION OF TRAINING TIME Australian General Practice Training (AGPT) has a policy for “Extension of Training Time”. A GP Registrar has a limited number of extensions available to them under the program. They consist of: 6 months extension for administration purposes (exams passed and paperwork lodged) 6 months extension to undertake exams 6 months extension for additional/related training (over and above the set program) Please ensure you read the policy, which can be found on the AGPT website as not all options are available in all instances. The GP Registrar should make every effort to complete their training within the three RACGP or four ACRRM years allotted. Bogong can only provide Registrars extra assistance to attain success in exams within the set 3 or 4 year training period, and not within an extension period. Therefore, Bogong encourages all Registrars to sit their exams early in GPT3 to allow time for extra assistance if required. GPRIME (Bogong’s On-Line Learning Platform) BRTN have introduced an online registrar information management system – GPRime, which maintains a record of your training, has tools to assist you in developing a learning plan, links to resources and provides information to you, your supervisor and your training advisor. A login tab is available to access GPRime from the Bogong website – www.bogong.org.au. You can login to the registrar area with a username and password. To change your password, click on ‘My contact details’ and enter your password and click on ‘Update details’. Under the “Forms and Documents” section you will find some “Cheat Sheets” which will guide you through the program. GPRime is also the place where all information, material and dates on workshops and other activities can be found. It is a mandatory requirement of the BRTN training program to create and continue to update a Learning Plan on GPRime. Contact the Bogong office if you experience difficulties with GPRime or forget your login details. All contact and correspondence from Bogong to GP Registrars is performed through this platform. Please ensure you maintain the currency of your address, phone and email on GPRime. 20 BOGONG GP TRAINING Registrar Handbook 2014 OVERSEAS TRAINED DOCTORS (OTDs) The term Overseas Trained Doctor (OTD) is interchangeable with International Medical Graduate (IMG). The term OTD will be used for the remainder of this section and for better understanding of, and in compliance with, the Health Insurance Act 1973 (Cth). What is a 10 year moratorium? To work in Australia, The Health Insurance Act 1973 (Cth) states that OTD’s and foreign graduates of an accredited medical school (FGAMS) will only be issues with a Medicare provider number if they work in areas deemed by the government to be a district of workforce shortage (DWS) for a maximum of up to 10 years – the moratorium period. In the Bogong GP Training region, most locations are classified Remoteness Area 2 (RA2) (Inner Regional) with a 9 year moratorium; with some locations classified RA 3 (Outer Regional) eligible for a 7 year moratorium. Registrars subject to Section 19AB of the Health Insurance Act 1973 (Cth) are required to train in the rural pathway. Exemption to the 10 year moratorium? Section 19AB of the Health Insurance Act 1973 (Cth), commonly known as the 10-year moratorium, provides exemption through amendments in 2010 and further amendments which took effect from February 2012. The 10-year moratorium does not apply where: The person was first recognised as a medical practitioner in Australia or New Zealand before 1997; The person was an OTD or FGARM prior to January 1997 and before that date had applied to undertake examinations to become a medical practitioner; or The relevant medical service is provided more than 10 years after the person first became a medical practitioner, and the person either first became a medical practitioner before 18 October 2001, was a permanent resident or citizen of Australia or New Zealand at the time of becoming a medical practitioner, or became a permanent Australian or New Zealander after first becoming a medical practitioner. Moratorium scaling From 1 July 2010 the concept of scaling was introduced as an exemption under Section 19AB of the Health Insurance Act 1973 (Cth) providing opportunity to reduce the moratorium period (from 10 years) by up to five years, depending on the Remoteness Area of the location where they practice. Bogong only has RA 2 & 3 locations, ie 9 years/7 years. New Zealand Doctors From 1 April 2010, doctors who were New Zealand citizens or New Zealand permanent residents at the time of commencement of a primary medical qualification gained in an accredited Australian or New Zealand university will no longer be subject to Section 19AB of the Health Insurance Act 1973 (the 10-year moratorium). Further information is available from the Department of Health and Ageing Workforce Regulation Section: 19AB@health.gov.au. BOGONG GP TRAINING 21 Registrar Handbook 2014 WHAT TO DO PRIOR TO COMMENCING A GP TERM Contact the practice manager and supervisor – at least two months before term begins. Ideally, meet faceto-face prior to commencing at Clinic. Discuss employment terms and conditions including accommodation. As soon as you are advised of your placement the following paperwork must be attended to: Recognition as a General Practitioner Provision of Provider Number Provision of Prescriber Number These forms can take up to 5 weeks to process, so lodge them as soon as possible. Without these, you will not be able to commence work at the practice, or be paid by Medicare. See below for how to obtain these. Registrar to provide to Practice Current certificate of medical registration from Medical Practitioners Board Proof of adequate current Medical Indemnity Insurance (including procedural if required) Prescriber number – see below Provider number – see below Copy of HIC letters confirming: ROMPS (Rural Other Medical Practitioners Program) approval, 19AB Exemption, entitlement to Medicare benefits if appropriate Tax File Number declaration form Details of nominated superannuation fund and fund membership number Password for billing and clinical software inclusion Letter from hospital confirming VMO appointment (if applicable) On commencement of your term the practice manager will have an employment pack containing other forms for signing, e.g. on-line Medicare claiming, Workcover etc. How to acquire provider and prescriber numbers Prior to your first placement in general practice it is vital that you have a provider number (a specific number for each site in which you will practice). This gives you access to Medicare payments. Without it you cannot be paid. Medicare cannot and will not backdate applications received after you have commenced work. The documents described in the following paragraphs must be lodged with the HIC at least 21 working days before your commencement date at a practice. It is your responsibility to lodge the documentation that defines your placement within an approved general practice. In particular, the dates of placements must be recorded correctly. Your practice manager is able to assist you with this. 22 BOGONG GP TRAINING Registrar Handbook 2014 There are two forms required for your provider number application: Application for Recognition as a General Practitioner Form This form is required along with the provider number application form. Go to GPRime “Forms & Documents” tab and download the form Complete the sections on Registrar Details and Approved Training Practice Details Practice manager then completes 'Approved Placement’ section Supervisor completes the Supervisor/Mentor Details section and signs it Practice Manager to fax the form to Bogong Office - 02 6024 7817 Bogong signs it and forwards it to GPET who further process the form and they send it to the HIC. The HIC will then match it with your Medicare Provider Application and will then finalise your provider number and prescriber number application. This process can take up to four weeks. Application for Medicare Provider Number Go to: www.medicareaustralia.gov.au download the ‘Application for a Provider Number for a Medical Practitioner’ form most people use the ‘apply for additional number’ form Remember you need a site-specific provider number for each workplace Complete registrar sections Your Practice manager or supervisor completes the practice section Post or fax directly to HIC (must be received at least 4 weeks before start of term) Your Provider and prescriber number will be posted to you Application for Medicare Prescriber Number Go to: www.medicareaustralia.gov.au Download the ‘Application for Prescriber Number for Registered Medical Practitioner’ form. NOTE: Before a Prescriber Number can be issued, you are required to attend a short educational course (about three hours) on issues such as claims, accounts, the Australian Medicare Benefits Schedule and Pharmaceutical Benefits Scheme (if not already done for another prescriber number application). Provider Numbers after Award of Fellowship On award of Fellowship registrars must send the following to HIC: Letter from the RACGP/ ACRRM confirming they are listed on the Fellowship Register RACGP/ ACRRM "Application for Recognition as a Fellow" HIC will then activate their provider number application within 7 days from the date it is received. BOGONG GP TRAINING 23 Registrar Handbook 2014 Other tasks prior to commencing term Meet/call your designated Training Advisor (the Bogong office can advise you who this is) Explore the ‘GPRime’ on-line learning platform which can be found on the BRTN website – on www.bogong.org.au Purchase stethoscope, ophthalmoscope, otoscope if not provided by practice Organise your doctor’s bag and, if required, prescription pads (PBS and Authority). To do this phone HIC (132 290) AFTER obtaining Provider Number and Prescriber number (discuss with GP Supervisor or Practice Manager) Organise emergency medications (check with your GP Supervisor) EMERGENCY MEDICINE COURSE As part of its workshop program, Bogong registrars undertake a “Rural Emergency Skills Training” (REST) course. This is a two-day workshop covering resuscitation BLS, ALS, and emergency procedures such as thoracocentesis and is funded by Bogong. Other emergency courses available are listed below. These courses are not funded by Bogong Regional Training Network. Emergency Life Support Ph: 02 6766 9119 Fax: 02 6766 9117 Email: elscourse@bigpond.com http://www.elscourse.com.au/ELS/Course/Introduction.asp Advanced Paediatric Life Support Ph: 03 9412 9222 Fax: 03 9415 9622 email: info@apls.org.au http://www.apls.org.au/ Early Management of Severe Trauma Ph: 03 9249 1277 Fax: 03 9249 1298 email: college.emst@surgeons.org http://www.surgeons.org 24 BOGONG GP TRAINING Registrar Handbook 2014 RECOGNITION OF PRIOR LEARNING Recognition of prior learning with time credit (RPL) GP Registrars may apply for recognition of prior learning with time credit (RPL) for their post-intern hospital training experience. For registrars granted RPL of their hospital training, they are eligible for up to a maximum of 52 weeks exemption from the time requirements of training. In order for RPL to be granted the following criteria must be met: The experience must have taken place in hospital posts accredited by the RACGP The rotations are approved by a Bogong medical educator as appropriate training fulfilling the requirements of the core disciplines of hospital training The applicant provides satisfactory documentation from the employing hospital of his/her hospital experience relating to the period for which RPL is being sought The applicant was unconditionally medically registered in Australia for the entire period Applications for RPL are made on the appropriate form, available for download on GPRime. Registrars who feel they may be eligible must apply within the first 3 months of beginning training in the AGPT program. RPL applications should be discussed with your training advisor. Applications are assessed by Bogong medical educators according to GPET, ACRRM & RACGP guidelines. RPL with time credit is only applicable after full registration RPL can also be used for Advanced Rural Skills Posts RPL applications must include a portfolio of documentation to provide evidence of the relevance of their prior learning to the learning objectives of training. Approval of RPL applications is the responsibility of a Bogong senior medical educator and the RACGP State Censor. Registrars who feel they may be eligible must apply within the first 2 months of beginning training in the AGPT Program. RPL should be discussed with your Training Advisor, who can assist with the application. RPL for ACRRM candidates can be applied for also. Please contact Dr Peter Keppel to discuss this further or via the ACRRM website. Recognition of prior learning without time credit (RC) Registrars may apply for Recognition of Prior Learning without time credit (RC) for their post-intern hospital training experience for either hospital or special skills or both. The same criteria must be met as for RPL. The difference to RPL is that applicants successful in gaining RC must complete a minimum of three (3) years of training. The purpose of obtaining RC is to ensure recognition is recorded of mandatory hospital rotations. BOGONG GP TRAINING 25 Registrar Handbook 2014 GP REGISTRAR PAYMENT & ASSISTANCE PACKAGE Rental/Relocation Assistance Bogong GP Training has funding available to assist Registrars in their relocation to the Bogong region. Funding will be available for training practices to invoice at a rate equivalent to $130 (plus GST) per week for the first year of community based practice (GPT1 and GPT2 only). The practice may disperse to the GP Registrar an appropriate taxable allowance, eg on a weekly basis. Payment is made to the practice in a lump sum at the commencement of each term. Practices are to invoice Bogong from commencement of the training term (for 26 week period) and submit a signed declaration with the invoice (Appendix S). Receiving the relocation assistance subsidy may have tax implications so should be carefully considered prior to invoicing - seek professional tax advice as appropriate. Removalist Assistance GP Registrars entering the program and moving into the region will be eligible for a relocation reimbursement. A one off payment (within the whole training period) up to a maximum of $2,000 will be available, and reimbursed directly to the registrar. The GP Registrar is to complete the appropriate form (available on GPRIME) and submit it with the relevant substantiated paperwork (e.g. tax receipts for the removalist). All claims will be individually assessed. Claims for petrol reimbursement will not exceed $600.00 if moving yourself. We are unable to support costs associated with further relocation within the Bogong region. Claims for relocation reimbursement must be submitted no later than 30 June in the relevant training year. Bogong’s financial assistance for Registrars will be reviewed annually and will only be available if funding allows. Travel to workshops Travel expenses to attend workshops or Training Advisor meetings are the responsibility of the registrar. Emergency Medicine Course (REST) All Registrars will be required to attend a Rural Emergency Skills Training (REST) course, the cost of which is met by Bogong. No other extraordinary courses are budgeted for and any individual requirements must be discussed with your Training Advisor in the first instance and with Dr Carolyn De Poi in relation to ARST, AST and FARGP requirements. 26 BOGONG GP TRAINING Registrar Handbook 2014 OTHER GRANTS AND SUBSIDIES General Practice Rural Incentive Program (GPRIP) See information sheet at back of Handbook. Rural Procedural Grants Program Both RACGP and ACRRM have been contracted by the Department of Health and Ageing to administer the Rural Procedural Grants Program (RPGP). It provides funding to assist GP proceduralists in rural and remote areas to maintain and upgrade their skills. Please see the ACRRM website www.acrrm.org.au or RACGP website www.racgp.org.au/rural/traininggrants HECS Reimbursement Scheme The HECS Reimbursement Scheme aims to promote careers in rural medicine and increase the number of doctors in rural and regional Australia in the longer term. The HECS Reimbursement Scheme reimburses HECS debts of medical students should they choose to train and work in rural and remote communities. Communities gain improved access to health services as more doctors move to work in these areas. Under the Scheme, doctors are able to reduce the period for reimbursement of the cost of their medical studies from five years to two years depending on the classification of their training or practice location according to the Australian Standard Geographical Classification – Remoteness Area (ASGC-RA). Further information including guidelines can be obtained at www.doctorconnect.gov.au or by contacting Medicare Australia on 1800 010 550. Department of Human Services (DHS) – Continuing Professional Development (CPD) for Rural GPs Subsidy Program The program enables GPs working in rural general practice in Victoria to claim up to $3,000 per financial year for CPD activities. Please contact RWAV direct o confirm what subsidies are currently available. For more information contact RWAV on (03) 9349 7800 or www.rwav.com.au. BOGONG GP TRAINING 27 Registrar Handbook 2014 EMPLOYMENT INFORMATION Guidelines for Leave A registrar is entitled to 4 weeks paid (by the employing practice) annual recreational leave per annum (prorata for part time). Any registrar seeking leave in excess of 6 weeks of annual recreational leave must apply for leave from the program, in advance, to Bogong Regional Training Network. Leave of absence may only be approved for up to one year. Leave of absence from the program is not approved for unsupervised work in general practice. Leave of absence from the program is not normally available in the first year of enrolment with the Training Program Registrars cannot commence training with leave of absence from the Program. Please refer to the AGPT Policy on www.gpet.com.au. Parental Leave Female GP registrars are eligible for parental leave of up to 12 months following the birth of each child. Male GP registrars are eligible for parental leave for up to 12 months per child/children where the GP registrar is to be the primary caregiver of the newborn child/children. Parental leave is similarly available to registrars who become legal guardians or adoptive parents. There is no limit on the number of periods of parental leave available for an enrolled registrar, provided the registrar continues to fulfil any requirements of the Training Program for a GP registrar on leave. Parental leave is in addition to the entitlement for elective time/leave of absence. Where both parents are GP registrars, either parent is eligible for parental leave but not both concurrently. At the completion of parental leave the GP registrar is normally expected to return to active training. Employment arrangements Registrars in GPT1 and GPT2 GP Terms are employed by practices in accordance with the ‘National Minimum Terms and Conditions’ (NMTC). Individual employment agreements are negotiated with your GP Supervisors and should be finalised prior to starting your GP Term. You should take the time to read through any proposed contract and compare it with the NMTC. A copy of the NMTC can be found on GPRime. You should retain a copy of your signed contract once appropriately negotiated. The GPRA also have a list of “Distinguishing features of employees/independent contractors” available on their website www.gpra.org.au. 28 BOGONG GP TRAINING Registrar Handbook 2014 SUPPORT STAFF Registrar Liaison Officer (RLO) The role of the RLO is to maintain regular contact with registrars and facilitate their input into future development, implementation and evaluation of the training program. The RLO can be a point of contact for Registrars with questions or concerns regarding their training. They are also able to represent local registrars on the GPRA. Our current Registrar Liaison Officer is Dr Erwin Wong. His contact details are available on pg 7. Registrar Board Member A BRTN registrar will be nominated for election as a Director of the Board of BRTN. If you have an interest in this position please contact the Executive Assistant to the CEO. Training Advisor (TA) Each registrar is allocated a Training Advisor prior to the commencement of their training. The role of the training advisor is to: Provide mentorship / career guidance Help the registrar to develop a whole of training career plan which addresses both clinical development and personal well being when career choices are being made. Assist the Registrar in completing applications for Recognition of prior learning o ( RPL ) or Retrospective credit ( RC ) Oversee the development and review the evolution of Registrar’s individual and specific learning plans and recording of those on GPRime. Meet at least twice per year – it is up to you to arrange these meetings. Medical Educators (ME) Medical Educators are experienced local GPs with an interest in education. They have responsibility for various educational roles within Bogong RTN, and coordinate the Education Workshops. They are available to assist with learning plans and education resources. Medical Educators may also be an active Training Advisor and Supervisor within a Practice. External Clinical Teaching Visitors (ECTV) ECT visitors conduct teaching visits to registrars within their current post. Visitors are experienced GP Supervisors based in the region. ECTVs provide a valuable learning opportunity and important feedback on your skills. The ECT visitor will sit with you for one session at an agreed time. The visitor will complete a feedback report on GPRime after the visit which you will have access to. BOGONG GP TRAINING 29 Registrar Handbook 2014 Direct Observations (or video) Direct observation is the observing and giving feedback by your Supervisor on clinical skills in the practice environment. It is one of the most valuable ways for GP Registrars to learn clinical skills and it is also the only way to really assess how a GP Registrar is performing with patients. These sessions will occur in addition to the required practice based teaching time for your GP term and your two (2) clinical teaching visits. It is useful when discussing these sessions with your GP Supervisor that you think about some of the barriers to direct observation and how you might try and minimise these during your direct observation sessions. If you have any concerns or issues regarding direct observation it is important to discuss these with your GP Supervisor. Your GP Supervisor will complete a feedback form on GPRime following each session and this will be available to you to help plan your ongoing learning during the term. It is highly recommended that you undertake your own video to reflect and learn from your consultations. Please speak to your practice manager about gaining patient consent, and access to video equipment. GP Supervisors The program’s principle teaching resource is our committed and enthusiastic group of GP Supervisors based in accredited private practices in the region. Practices are all accredited teaching practices in accordance with the current RACGP or ACRRM Standards for Training Posts. Supervisors meet regularly to share teaching and learning skills. GP Supervisor Liaison Officer (SLO) The GP Supervisor Liaison Officer provides a point of contact between GP Supervisors and Bogong RTN. They also represent local GP Supervisors on the National GP Supervisors Association. Registrar Assistance Program Should a registrar have difficulty meeting the requirements of training, Bogong may initiate some learning assistance. As Bogong is committed to training GPs to achieve vocational registration, it is important to know if a registrar is having difficulties. An assistance plan enables Bogong to provide extra supervision and tuition as required to ensure a registrar achieves their goals of FRACGP or FACRRM qualification for unsupervised general practice. Areas of assistance include: Extra teaching time Communication and Language Support (CLS) Study Group Extra ECT visits and direct observations. Most of this assistance can only be given during the core training years and not during ‘extension of time’. 30 BOGONG GP TRAINING Registrar Handbook 2014 COMPLAINTS AND GRIEVANCES In the event of a dispute arising involving a GP Registrar, trainer or member of the Bogong staff the disagreement will be discussed and a resolution attempted. Four stages have been developed for this purpose: Stage One The complainant, their supervisor and an independent party shall discuss the issue and develop a solution. Resolution is by consensus agreement. This group may meet face to face or by teleconference. The resolution of any dispute requiring the involvement of the above group must be reported in writing by an employee of Bogong to the CEO of Bogong and must be acceptable to him/herself and the Board of Bogong. Stage Two If the issue cannot be resolved at Stage One a group consisting of the parties to the complainant, with representatives, and the CEO will be convened. The CEO will chair the meeting. This group may meet faceto-face or by teleconference. Resolution will be by consensus agreement. Stage Three If the dispute is not settled through the Stage Two mechanism the disagreement shall be brought before the Board of Bogong. Both parties to the dispute must be present and may be represented by a nominee of his or her choice. This meeting may be face-to-face or by video or teleconference. After hearing submissions from both parties to the dispute, the Board shall meet in private and the Board shall make a decision on the matter by majority vote. Stage Four Further avenues for appeal depend on the parties in dispute. If one of the parties is a GP Registrar – arbitration by the GPET Appeals Panel is the appropriate course of action. If one party is a trainer/ supervisor – arbitration by an appropriate body can be called upon. While the dispute and the dispute resolution mechanism remains contained within the processes of Bogong, costs other than any costs associated with the complainant obtaining legal advice or service, will be borne by Bogong. At no stage will any legal or associated costs be borne by Bogong on behalf of the complainant. A copy of the Bogong Policy is available on GPrime. BOGONG GP TRAINING 31 Registrar Handbook 2014 USEFUL RESOURCES In addition to this handbook, it is recommended that registrars embarking on vocational training through BRTN read over the following important documents. GPET Handbook: The Australian General Practice Training Guide for GP Registrars is the key reference on current policies, requirements and features of vocational training for general practice. It provides information on the Training Program, details of eligibility and arrangements for teaching and supervision in training posts. This handbook can be found on the AGPT website www.agpt.com.au and on GPrime. RACGP Curriculum: The curriculum document outlines the knowledge base to be covered toward attainment of the FRACGP. A copy of the curriculum document can be found on the RACGP website. See http://www.racgp.org.au/curriculum ACRRM Primary Curriculum: This is intended for those who may wish to pursue attainment of the FACRRM. The document covers the knowledge base for the FACRRM, which provides recognition of specialist skills in Rural and Remote Medicine as a distinct specialty area. This encompasses some more advanced specifically ‘rural’ skills. See http://www.acrrm.org.au for the curriculum. Recommended texts for General Practice Murtagh’s General Practice 4th Edition, 2007, and Companion Handbook Practice Tips – Murtagh – 3rd edition/2000 – surgical techniques, other procedures Royal Children’s Hospital Paediatric Handbook – (Melbourne) – Paxton Clinical Sports Medicine – Brukner & Khan Therapeutic Guidelines – practice should have copy on computer, or online password Australian Medicines Handbook – yearly updates. Usually receive this free with RACGP membership From RACGP (once you have financial registrar membership) – www.racgp.org.au: ‘Australian Medicines Handbook’ ‘Australian Family Physician (AFP)’ – journal of general practice. Has ‘clinical challenge’ questions at rear of journal ‘Check’ program – exam-style practice questions with answers and clinical info sent out each month. Sent out in plastic package monthly with the AFP journal 32 BOGONG GP TRAINING Registrar Handbook 2014 Other useful resources: Medical Observer – you’ll automatically be sent these ‘newspaper’ style medical news updates ‘Australian Doctor’ – the ‘How to treat’ sections are very useful GP Learning www.gplearning.com.au - good website with multiple choice style questions Audio Pod casts – on RACGP website www.racgp.org.au – see pod casts section on left-side menu. Good for learning on car trips! Others on GPRA website www.gpra.org.au ; also ‘drive time’ CDs sent out regularly www.dermnet.nz – good dermatology site ‘Up to Date’ – Bogong provides each clinic with this (CDs updated regularly); ask you Practice Manager for an online password. A useful resource for most topics. Fitzpatrick’s Dermatology Atlas Ophthalmology texts – multiple available “Clinical Cases for GP Exams”, Susan Wearne – has history and patient instructions so you can practice for the clinical exam. A copy of this book should be in your Practice. Rural Health Education Foundation (RHEF) Satellite Broadcasts and CDs; www.rhef.com.au/upcomingprograms/ Palliative Care – The Nitty Gritty Handbook Registrar Practice Pack BRTN have been fortunate enough to supply all our Accredited Practices who have a GPT1/GPT2 Registrar training with them a “Registrar Resource Pack”. The pack is to be available for use by the Registrar and includes the following items: ThermoScan Lumi-View Vorothscope Headlamp Dermatoscope Diagnostic Set with Otoscope and Coaxial Ophth Family Multi Cuff Kit Hi-Bebe Foetal Ultrasound Doppler Thermoscan & Finger Tip Pulse Oximeter Text Books: Harrisons Principles of Internal Medicine and Oxford Textbook of Medicine Murtagh’s General Practice 4th Edition, 2007, and Companion Handbook Up to date (online resource) Therapeutic Guidelines (online) The pack remains the property of BRTN and must remain at the practice at all times. BOGONG GP TRAINING 33 Registrar Handbook 2014 WHOM TO RING AT BOGONG REGIONAL TRAINING NETWORK Linda Moon CEO Sue Porter Executive Assistant Deanne Sweetland Operations and Training Manager Robyn Matthews Karen Dixon Finance and Business Manager Program Development Manager Mary-Anne Scully Isabelle Swanson Marketing and Communications Officer Education Program Co-ordinator Jo Hamilton Training Administrator Jane Delaney Administration and Records Assistant Robyn Bottrell Finance Officer Julia McCourt Training Administration Assistant Jenna Peerman Administration Assistant Glen Collins Peter Wyman ICT Officer IMG Project Officer 34 Governance Board matters Complaints/Grievances Registrar Remediation Executive support to CEO & Board Admin support to Business Manager Governance Diary coordination and Promotional Activities Training Time Calculations Registrar Placement and Practice Match GPRIME Registrar remediation Registrar Recruitment Operations Management Budgets / Funding OTDNet ACCRM WBA IMG Program Press Releases Newsletter/Media material Registrar enquiries Registrar Workshop Co-ordinator REST course ARST / Extended Skill posts / AST Registrar enquiries New Registrar Intake Practice and Supervisor Accreditation PGPPP GPRIME Practice Managers Workshop Supervisor Workshops Registrar Recruitment RPL and ESL queries, GPRIME Training Time Calculations Provider No. Forms Registrar enquiries Completion of Training Registrar accounts Subsidy + relocation queries Practice Invoices ECT Visits Registrar and Practice enquiries General Queries GPRIME login + passwords Registrar Enrolment Practice Profile on website Direct Observations Computer and technology related issues IMG Program Shepparton (03) 5823 3200 BOGONG GP TRAINING Registrar Handbook 2014 APPENDICES Acronyms Things to do in the region Organisations – State and National GPRIP Fact Sheet Distinguishing features of employees/independent contractors Bogong Regional Training Network’s Privacy Policy Bogong Learning Task (BLT) Sign off sheet BOGONG GP TRAINING 35 Registrar Handbook 2014 Acronyms ACRRM AGPT AMA ARST ASGC-RA AWRGPN BLT BRTN CPD CME ECTV ES FACRRM FARGP FRACGP GP GPET GPR GPRIP GPRime GPRA GPS GPSLO GVGP IMG ME NEVDGP OTD PGPPP PLW RACGP RC RDAA RDANSW RDAV REST RPL RLO RMFN RRIPS RRMEO RTP RWAV TA VR 36 Australian College of Rural and Remote Medicine Australian General Practice Training Australian Medical Association Advanced Rural Skills Training post Australia Standard Geographical Classification – Remote Areas Albury Wodonga Regional General Practice Network (Formerly Border Division of General Practice) Bogong Learning Task Bogong Regional Training Network Continuing Professional Development Continuing Medical Education External Clinical Teaching Visit Extended Skills post Fellowship of ACRRM qualification Fellowship of Advanced Rural General practice qualification Fellowship of RACGP qualification General Practitioner General Practice Education and Training Ltd General Practice Registrar General Practice Rural Inc Program GP Registrar Information Management and Education General Practice Registrars Australia General Practice Supervisor General Practice Supervisor Liaison Officer Goulburn Valley Division of General Practice International Medical Graduate Medical Educator North East Victorian Division of General Practice Overseas Trained Doctor Prevocational General Practice Placement Program Peer Learning Workshop Royal Australian College of General Practitioners Retrospective Credit Rural Doctors Association of Australia Rural Doctors Association of New South Wales Rural Doctors Association of Victoria Rural Emergency Skills Training course Recognition of Prior Learning Registrar Liaison Officer Rural Medical Family Network Registrar Rural Incentive Payment Scheme Rural and Remote Medical Education Online Regional Training Provider Rural Workforce Agency Victoria Training Advisor Vocational Registration BOGONG GP TRAINING Registrar Handbook 2014 Things to do in the Region ACTIVITIES Canoe along the Murray River…..Albury Backpackers Wine tasting…..Rutherglen, Milawa, King Valley, Alpine Valleys, Nagambie, Seymour, Downhill skiing, Cross-country skiing, snowboarding…..Mt Buller, Falls Creek, Mt Hotham - see local ski shops for reduced price ‘local’s tickets’ Water-skiing on Lake Mulwala and Lake Hume Bushwalking Road cycling or mountain biking Ride along the rail-trails Visit our historic towns such as Beechworth, Chiltern, and Yackandandah Fishing Gliding and Paragliding Ballooning Play golf Horse riding Many nice restaurants/cafes FESTIVALS Opera in the Alps Dederang Picnic Races Myrtleford Festival Tastes of Rutherglen Yackandandah Folk Festival Bright Autumn Festival Beechworth Harvest Festival Rutherglen Winery Walkabout Ski season opening Thredbo Blues Festival Beechworth Celtic Festival Brown Brothers Wine & Food Festival La Dolce Vita Festival Wangaratta Jazz Festival Carols in the Alps January January March March March April - May May Queen’s birthday weekend June Queen’s birthday weekend June October November November November November December For detailed information on local attractions and facilities access: www.alburywodongaaustralia.com.au www.greatershepparton.com.au www.visitwangaratta.com.au BOGONG GP TRAINING www.murrayriver.com.au www.visitvictoria.com www.riverinatourism.com.au 37 Registrar Handbook 2014 Organisations – State and National GPET General Practice Education and Training GPO Box 2914 Canberra, ACT 2601 Ph (02) 6263 6777 Fax (02) 6263 6788 gpet@gpet.com.au www.agpt.com.au AMA Victoria Australian Medical Association VIC 293 Royal Parade Parkville, VIC 3052 Ph 1800 810 451 Fax (03) 9280 8786 amavic@amavic.com.au www.amavic.com.au ACRRM – Head Office Australian College of Rural and Remote Medicine GPO Box 2507 Brisbane, QLD 4001 Ph (07) 3105 8200 Freecall 1800223266 Fax (07) 3105 8299 acrrm@acrrm.org.au www.acrrm.org.au AMA NSW Australian Medical Association NSW PO Box 121 St Leonards, NSW 2065 Tel: (02) 9439 8822 Tollfree: 1800 813 423 Fax: (02) 9438 3760 Tollfree: 1300 889017 www.nswama.com.au RACGP – National HQ Royal Australian College of General Practitioners RACGP College House 1 Palmerston Crescent South Melbourne, VIC 3205 Ph (03) 8699 0414 Fax (03) 8699 0400 racgp@racgp.org.au www.racgp.org.au RDAV Rural Doctors Association of Victoria PO Box 75 Mount Beauty, VIC 3699 Ph: Kathy 0408 278 052 execassist@rdav.com.au www.rdav.com.au General Practice Registrars Australia GPO Box 78 Canberra, ACT 2601 Ph 1300 131 198 Fax 1300 650 223 enquiries@gpra.com.au www.gpra.com.au RWAV Rural Workforce Agency of Victoria Level 2.20 Queen Rd Melbourne, VIC 3001 Ph: (03) 9349 7800 Fax (03) 9320 0401 www.rwav.com.au RMFN Rural Medical Family Network 458 Swanston Street Carlton, VIC 3053 Ph (03) 9349 7800 Fax (03) 9349 4211 rmfn@rwav.com.au www.rwav.com.au/rmfn 38 BOGONG GP TRAINING Registrar Handbook 2014 Organisations – Regional North East Health Wangaratta Green St Wangaratta, VIC 3677 Contact: Ellen Hudson Ph: (03) 5722 0260 Goulburn Valley Health Graham St Shepparton, VIC 3630 Contact: Mandy Polan Ph: (03) 5832 2739 Albury/Wodonga Regional Health Service Wodonga Campus Vermont St Wodonga, VIC 3690 Contact: Linda Moon Ph:(02) 60517543 Albury/Wodonga Regional Health Service Albury Campus Borella Rd Albury, NSW 2640 Contact: Linda Moon Ph: (02) 60517543 University of Melbourne Department of Rural Health PO Box 6500 Shepparton, VIC 3630 Contact: Dr Graeme Jones Ph: (03) 5823 4500 Fax: (03) 5823 4555 University of New South Wales Department of Rural Health P O Box 3004 Albury, NSW 2640 Contact: Dr Peter Vine Ph (02) 6058 4615 Fax (02) 6042 1300 Hume Medicare Local 594 Hovell St PO Box 651 Albury, NSW 2640 Contact: David Dart Ph: (02) 6041 0000 Fax: (02) 6041 0041 Goulburn Valley Medicare Local 226 Wyndham St PO Box 1074 Shepparton, VIC 3632 Contact: Phillip Bain Ph: (03) 5831 5399 Fax: (03) 5831 5398 BOGONG GP TRAINING 39 Registrar Handbook 2014 GPRIP Fact Sheet Retention Component Q1.1 What is the new General Practice Rural Incentives Program? The new General Practice Rural Incentives Program (GPRIP) will replace the Registrars Rural Incentive Payments Scheme (RRIPS), which applied to GP Registrars on the AGPT program, and the Rural Retention Program, which applied to GPs. GPRIP will also include a Relocation Incentive Grant component. The new incentives program will provide a consistent set of incentive payments that applies on an equivalent basis for GPs and Registrars practicing in rural locations. Under RRIPS, GP Registrars were eligible for higher grant payments. This new program will streamline the administration of incentive payments and provide parity between GPs and GP Registrars. The level of incentives will now be based on the Australian Standard Geographical Classification – Remoteness Areas (ASGC-RA) classification system. Q1.2 When will the General Practice Rural Incentives Program start? GPRIP will start from 1 July 2010. For GPs, this means payments falling due form the September quarter onwards will be calculated according to the new rules. Q1.3 How will GPRIP work for GPs? The retention component will work in a similar way to the current Rural Retention Program. However, the payment rates and qualifying periods will change. Incentives will be paid according to a sliding scale based on the ASGC-RA category and the length of time in a rural location outlined below. Period of time (years) in a rural location ASGC-RA Classification 0.5 1 2 3-4 5+ RA2 - $2,500 $4,500 $7,500 $12,000 RA3 $4,000 $6,000 $8,000 $13,000 $18,000 RA4 $5,500 $8,000 $13,000 $18,000 $27,000 RA5 $8,000 $13,000 $18,000 $27,000 $47,000 Under GPRIP, doctors will become eligible for an initial payment earlier and will be able to receive much higher retention payments than were previously available to GPs. 40 BOGONG GP TRAINING Registrar Handbook 2014 Q1.4 Which payment rate will I receive if I have already been receiving payments under the current Rural Retention Program? The payment rate will be determined based on the number of years (measured in active quarters) of service the doctor has completed in one or more ASGC-RA 2-5 locations. Q1.5 What will happen if the new payment rate is lower than it would have been under the Rural Retention Program? Receiving RRP payments Doctors that become eligible for an RRP payment before 1 July 2010 (payments falling on or before the June quarter 2010) and have maintained their continuous service requirements will receive whichever is the greater of the new payment rate or the payment they would have received had the Rural Retention Program continued. Completing RRP qualifying period Doctors that, at 1 July 2010, are completing a qualifying period under the Rural Retention Program and have maintained their continuous service requirements will receive whichever is greater of the new payment rate or the payment they would have received had the Rural Retention Program continued. New to rural areas from 1 July 2010 Doctors that move to a rural area after 1 July 2010 will be subject to the GPRIP payment rates and rules. Q1.6 Are Specialists eligible for GPRIP? GPRIP is aimed at retaining general practitioners. The services eligible for GPs will be the same as those currently eligible under the Rural Retention Program. These are clinical services that are equivalent to the General Medical Services Section of the Medicare Benefits Schedule book. This includes: Category 1 – Professional attendances Category 2 – Diagnostic procedures and investigations Category 3 – Therapeutic services Eligible services do not include diagnostic imaging, pathology services, dentistry or optometry. Q1.7 What is the ASGC-RA category of my practice location? How can I find out which ASGC-RA category a location is in? A web site has been established for people to determine the ASGC-RA category of any location. This can be accessed by visiting www.doctorconnect.gov.au and clicking the link on the homepage called “Remoteness Area Locator”. Q1.8 Will there continue to be a Flexible Payments System under GPRIP? Yes. The Flexible Payments System will continue but assessment will transfer to the new rules for the Program. Q1.9 Will my eligibility accrued as a Registrar continue when I become a GP? Eligibility gained by Registrars can be retained on becoming a GP. For this to happen the period from the last Registrar payment to the first GP payment must satisfy the continuous service requirements under the rules for GPs (this means maintaining four active quarters in every eight). BOGONG GP TRAINING 41 Registrar Handbook 2014 Distinguishing features of employees/independent contractors Features of relationship Lawful authority to command How is the work performed? Risk Place of performance Hours of work Leave entitlements Payment Expenses Appointment Termination Delegation Employee (contract or services) Contractor (contract for services) Employer has the right to direct the way in which work is done At the request of the employer Contract is for a given result. Contractor works on his/her own Contract for a specific task/series of tasks. Contractor has high level of discretion and flexibility as to how to perform the tasks. Contract may, however, specify precise terms such as methods of performance Independent contractor bears the commercial risk and responsibility for poor work in performing the task Contractor provides own assets and may work at a number of locations Sets own hours of work No leave entitlements Employee bears little or no risk which is borne by the employer. The employer is generally responsible for any loss resulting from poor work Generally at the employer’s premises Standard/set hours General entitlement to annual leave, long service leave, sick leave, etc. Generally paid on hourly basis/award rates Reimbursed for expenses incurred during employment Generally recruited via advertisement placed by employer/agency/approached by employer May dismiss at any time – subject to state/federal laws Employee cannot delegate tasks (except for delegation of duties to others as part of the role) Equipment Usually provided by employer Scheduling of work Expectation of work Method of payment Taxation Relationship to business Ability to accept other work Right to refuse work Determined by employer Ongoing expectation Usually per award/employment agreement Employee pays PAYG tax (via employer) Employee is usually integral part of business Usually restricted to work for one employer during agreed hours Cannot refuse reasonable task Payment subject to performance of the contract Responsible for own expenses Advertises services to the public at large May only terminate if breaches contract by agreement Contractor may delegate all or some tasks and may employ other persons to assist (unless contract expressly precludes this) Contract usually specifies who will provide equipment – usually contractor Determined by agreement between the parties Usually engaged for a specific task/period Usually invoices Contractor usually pays own tax Contractor’s work usually accessory to business Can work for other clients Contract governs tasks to be performed which are agreed in advance *Extract from GPRA website 2011 42 BOGONG GP TRAINING Registrar Handbook 2014 Privacy Policy – Bogong Regional Training Network Detail The purpose of this document is to outline Bogong Regional Training Network’s privacy policy, explain how it will affect our clients and how their personal details are used and protected. The Privacy Act and the National Privacy Principles (NPP) apply to the collection, use and disclosure of an individual’s personal information relating to companies or businesses. What is personal information? Personal Information is any information relating to an individual that is held in a record by an organisation, such as your name and address. What is sensitive information? Sensitive information is personal information such as health information and information about personal attributes such as ethnic or racial origin, membership of organisations such as trade unions, religious or political affiliations. How and why Bogong collects your personal information Information is usually collected by phone, email, fax or questionnaire at personal meetings. The information gathered is necessary to assist Bogong in its function of providing general practice education and training and related services Bogong needs your consent in order to use your information, in accordance with the Privacy Act and the NPPs. In some instances, if you do not provide consent, we may be unable to assess or process your information to provide you with the programs or services you require. Protection and security of your personal information Bogong maintains the confidentiality and security of your personal information by restricting access to those staff and service providers required to provide management and administration services. A range of security measures is also in place designed to prevent the misuse, unauthorised access, modification or disclosure of your personal information. Disclosure of your personal information to other parties It will be necessary for Bogong to disclose your personal information to certain third parties in the managing and administering of your vocational training program. Examples of the types of organisations to which we may disclose your information include: Medical Educators employed by Bogong GP Supervisors and Training Practices in the Bogong region; Organisations undertaking compliance reviews of the business or reviews of the accuracy or completeness of the information; Organisations undertaking evaluation of the operations of Bogong. Organisations providing: maintenance of our information technology systems; printing of our standard documents and correspondence; financial transaction services. BOGONG GP TRAINING 43 Registrar Handbook 2014 Organisations providing educational programs or other services that may be beneficial to your training including General Practice Education and Training, Royal College of Australian General Practitioners; Australian College of Rural & Remote Medicine; Border Division of General Practice, Goulburn Valley Division of General Practice, North East Victorian Division of General Practice; Board of Directors of Bogong Regional Training Network Limited. Bogong endeavours to ensure that any individual or organisation to which it discloses your personal information, has appropriate privacy protocols in place. Where you wish to authorise any other parties to act on your behalf, or to receive information, please notify us in writing. Bogong does not supply, sell or rent its clients’ information to any unrelated third parties for the purpose of those third parties marketing their products or services to you. However Bogong will disclose your personal information in circumstances where it has statutory obligations or is required by law to do so. What to do if you have a Privacy Complaint Bogong is committed to resolving your privacy complaint as quickly as possible and has procedures in place to help resolve any problems or complaints efficiently. Its aim is to assist you by reaching a satisfactory solution as soon as possible. Bogong may also exercise its right to deny access to particular information in certain circumstances, such as when legal proceedings may have commenced. If access to your personal information is denied, Bogong will explain the reasons why. Quality of your information Bogong relies on the correctness of the information you supply. Please contact Bogong if any of your personal information is incorrect, has changed or requires updating. This includes your name and address, phone numbers and email contact address. How long is your personal information kept? Your personal information is kept as long as it is required to provide the training services that you receive via Bogong. It will then be Archived in our filing system for a further seven years. FOR FURTHER INFORMATION If you have any questions about privacy, wish to access your information, or are concerned about privacy at Bogong Regional Training Network Limited please email Bogong Regional Training Network Ltd at bogong@bogong.org.au. You will be contacted within 24 hours of your email being received. 44 BOGONG GP TRAINING Registrar Handbook 2014 Bogong Learning Task (BLT) Instructions for Registrar A useful educational skill for GPs is to be able to research a topic and present to a group of colleagues. The Bogong Learning Task (BLT) requires GP Registrars to research and present a topic during the PLW program. Generally, the presentation will take the form of a Power Point based presentation, but different formats such as the development and facilitation of skills stations or role plays, or the development of an on-line based presentation, might be negotiated. Topics might link with themes from the education workshops or be allocated depending on areas of expertise or need. Your GP supervisors will assist with resources and suggestions for the presentation task. Please read through the details of the task below, check of each step as you complete each part of the task, and, be sure to ask one of the Medical Education Team if you have any concerns. Task Detail Completed Step 1 – Allocation of topic and task Your topic will be allocated by the Medical Education team. You will receive a detailed scenario and issues that you will need to address. If you have any concerns or questions, please clarify as soon as possible with the appropriate Medical Educator. Yes No Yes No Yes No Step 2 - Research You are required to engage in broad research - that is applicable to General Practice. This will include meeting with you GP supervisor, but could include PubMed Searches, reading textbooks and journal papers, searching websites for clinical guidelines, discussing with colleagues (and Specialists) and so on Research - Define the clinical question you are investigating - find the right information resource to search for answers to your question(s) - appraise or rate the information on a ‘quality’ basis - Reference information well. (Note that ‘K.Davey 2012’ is not adequate!) Step 3 - Prepare draft presentation Components of your presentation: - Session plan or “running sheet” to guide you through the actually presentation to your peers - Supporting PPT…to augment your presentation - Handout – short summary of key points / implications - References / resources accessed and used, including quality? BOGONG GP TRAINING 45 Registrar Handbook 2014 Task Detail Completed Step 4 – Collaboration (would miss step 4 if completing individually) You will need to meet with your “Buddy Registrar” who has been given the same topic and scenario. You should share and discuss your draft presentations, taking opportunities to moderate and build on each other’s work. Make sure that you share all 4 components of your draft presentation. - Session plan / running sheet - PPPT - Handout - summary of key points/ implications - References / resources used Task Detail Yes No Completed Step 6 – Review, and preparation of final presentation Use feedback from moderation to inform final presentation Yes No Yes No - Session plan - PPT - Handouts - References / resources used Step 7 – Preparation for actual presentation at workshop - Final copy of ppt, session plan, handout and references /resources used to be given to Bogong Office - 1 week prior to workshop Any final concerns to be discussed with supervisor / buddy Step 8 – Presentation at workshop - Check that technology works, ppt ready to go, handouts available - Ensure total familiarity with content - Stand to make presentation - Speak loudly and clearly - Ensure suitable introduction and close of presentation - Encourage the group to ask questions and make comments Step 9 – Feedback A Medical Educator will to talk with you and provide feedback based on the checklist below 46 BOGONG GP TRAINING Registrar Handbook 2014 Feedback Checklist (used by the Medical Educators) The Medical Educators will use the following checklist as a basis to providing you with feedback about your Bogong Learning Task Workshop: Topic: Registrar name: Medical Educator Name: Things to look for: Comments Preparation Session plan Ppt Handouts List of references Introduction to the Session introduce topic explain the objective/outcome of session check existing knowledge spark interest Content / research defined critical question research applicable to GP quality research suitable response to scenario appropriately referenced Communication Skills Encourages questions Listening Clarifying Responds effectively to questions Summarising to move on Facilitation Skills Movement Enthusiasm/ Energy Knowledgeable Confident with subject matter Provokes thought Close of Session Summarises key points (outcomes) covered Asks for questions Thanks group for participation Options for future learning General Comments BOGONG GP TRAINING 47 Registrar Handbook 2014 Registrar Handbook – Sign off sheet It is critical that you have read and understood the information in this Registrar Handbook. Although a number of the topics covered in the handbook will be addressed during the Orientation Workshop, you are required to have read through the handbook and identified any concerns or questions you might have, prior to that workshop. If you do have any questions, please bring them to the Orientation Workshop. If we are unable to answer all questions during the workshop, we will contact you in the following couple of weeks. Please indicate that you have read through the Registrar Handbook by signing and dating below. I have read the Bogong Registrar Handbook and have / will email any unresolved issues I might have to bogong@bogong.org.au Registrar Name: Registrar Signature: Date: 48 BOGONG GP TRAINING
