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Rural Health Webinar Series – The How and Why of Becoming a Supervisor in your Rural Practice

 How and Why of Becoming a Supervisor in your Rural Practice
 
Dimitri

Good evening, everyone. My name is Dimitri and I will be hosting tonight's webinar. This instalment of the Rural Health Webinar series will provide an introduction to the benefits and essential steps involved in becoming a supervisor in a rural setting. We will explore the role of a supervisor, the positive impact you can have, and a clear roadmap to getting started. You will learn about the importance of the supervisor role, how it contributes to the development of the rural GP workforce, and why it is such a fulfilling and vital position in our rural communities. Our presenters this evening are Dr Gerard Ingham and Dr Rod Omond. I will hand over to Rod now to get things started. We also have Jess O'Brien joining us today. Jess is our admin officer in the rural faculty and she will be observing this evening as well.
 
Dr Rod Omond

Thank you and good evening everyone. We would like to begin tonight's webinar by acknowledging the traditional owners of the lands that we are coming together from and the land on which this event is being broadcast. I would like to pay our respects to their elders, past and present, and would also like to acknowledge any Aboriginal or Torres Strait Islander people who have joined us this evening. Just before we start, there is a few housekeeping things to cover. Participants in this webinar set on mute to make sure the webinar is not disrupted by background noise, but we encourage you all to use the Q&A chat to ask questions.

There is a Q&A button that you can push down the bottom to open that up and put your question in there. I will be watching that during the webinar, and finally, the webinar has been Accredited for one hour of educational activities CPD. To be eligible you must be present for the duration of the webinar. We also kindly ask that you complete the short evaluation at the end of the webinar, just to let us know how it went and what things we did not tell you, and that we should have that sort of thing. It only takes a few minutes to complete and it will help us to improve this format. That is what I do against a rather younger picture of me, I think I am cheating there.

We are allowed to do that when you are over the age of 60, are not you? I work with RACGP as a medical educator and help out with advice to the supervisors and the supervisor CPD for the fellowship support program. I am involved with that program in the college. I have been working in indigenous medicine in the Northern Territory for 15 years and was up in Darwin and flew regularly to the Tiwi Islands, and now I practice from home remote urgent and retrieval medicine for the top end remote communities. I have a research interest in point of care testing in those remote communities, testing a new machine at the moment for blood counts, and I am also just, so you are aware, the deputy chair of the rural faculty counsel, in case you have got questions along that line which I might be able to answer not quite on our topic tonight. Over to you, Gerard.
 
Dr Gerard Ingham

I am Gerard Ingham, also a slightly younger photo, not that long ago though. I am a rural GP and I am over 62, so I am a rural GP and was a practice owner in Daylesford for over 30 years, but I was currently working in NATO in the Northern Territory. Through my career as being a supervisor has been a main part of what I have done. I have been involved in supervision of over 100 registrars RACGP and ACRRM and all stripes and types. I am a medical educator and I am the RACGP National Clinical Lead for Supervisor and Practice Support and ±«ÓãÊÓÆµ, hence the reason I am speaking to you tonight, and I am also become an academic with a research interest in GP supervision in vocational training.

The learning outcomes, we want you to be able to understand the role of a supervisor, identify the benefits, navigate the initial steps to becoming a supervisor and be aware of available support systems. Just as an educator, you always want to start out and get a bit of a sense of your and a webinar is a strange format when you are speaking to the void. I want to get a bit of an idea of which of the following best describes you? I am going to ask Dmitri to post the poll and if you could answer that and respond to that question.
 
Dimitri

I think we have got a couple of responses already coming through.
 
Dr Gerard Ingham: Get a few in and then to do because there will be people here, I am guessing, who are currently supervisors, so just coming along to get the see if they are doing it the right way, and then those who are looking to restart and those who have never been a supervisor and maybe some others, and if you are another, I will ask you to type your answer in the chat rather than the Q&A. If you can put that in there, it would be good. Let us see the results. Have we got any results? Dmitri? Is everyone eating their tea? And I am able to get across to it. Okay. Currently a supervisor, never been an official, and no one looking to restart. The predominance of our audience, a sample of eight there, but majority have never been a supervisor, so hopefully we will have some information that is entirely relevant to you. For some of you tonight, it is a bit like I found this picture in the RACGP library archives.

You experience as a GP, when you open up the cupboard and hope there is something useful in there, and that might be a bit how you are, oh, I want to just find out what about supervision and look at that and see if it is for me. Unfortunately, I would have to say when you open the cupboard, you will find that our training programs are incredibly complex and they become complex really because of historical political purposes, and we have had original training programs and they keep being changed all the time, and rather than well, I would say in fact, they are actually a dog's breakfast rather than being edited and changed, they keep getting added to and made and frequent small changes as well. When I am telling you about the complexity of this system, please do not shoot the messenger. I am someone who identified this and published in the Medical Journal of Australia, pointing out that this complexity was not helpful for supervisors, and I called for action to address some of the inequities, particularly the fact that there was supervision in some programs and not in others that there was payments in some and not others, and overall, there is a dearth of payment for supervisors for actually doing the work of supervising, going in and seeing the patients and called for an MBS item for supervision, but that is not our topic tonight. Please do not shoot me. I am aware that how difficult it is.

I am still going to take you briefly through the relevant training programmes which you, as a rural GP, may have to interact with. The first one, the most well-known one, is the Australian General Practice Training Program or AGPT. It is a three year. It becomes an additional year if you do a rural generalist and you need a diversity of practice requirement, that is, you have to work in more than one practice over your training. It is government funded, so there is no cost to the registrar, and at the end you either run either by RACGP or ACRRM and you obtain a fellowship after completing the training and passing the exam. Importantly, the registrar is employed and they are employed under the National terms and conditions. The NTCER, which is negotiated between GPSA, GPRA and the AMA. Practices receive the following payments, and you perhaps go to the GPSA website if you want to see them in detail, but they come from the government, the nationally consistent payments called NCP under the RACGP under Flexible Funds. All of these payments go straight to the practice and are supposed to be disbursed to the supervisor relevant to their contribution to teaching, and as you can see there, I have listed some of the costs.

You basically get more the if it is a GPT-1 or GPT-2, you get more if you are MMM 6 or 7 compared to MMM 1 and Such like. The next one which is Rod's special interest is the fellowship support program. This is a three-year program additional year if you are doing rural journalism, but importantly there is no diversity of practice requirement during training. It is self-funded by the registrar. There is the fees there, $20,000 for year one and $12,000 for year two. You might be saying, well why would a registrar, why would someone choose this program over the fully funded other program. Basically, there are many reasons, but I wrote a few things, but the main two that I would see is the ability that they have certainty about where they are and where they are going to remain, and often they might already be in the practice. Also they are not bound by the national terms and conditions, and so they can earn different amounts, work more hours, and they may feel that they come out in front both from a lifestyle and a financial point of view. Would that be true? Rod, do you think?
 
Dr Rod Omond
 
Yeah, I think that is a pretty good summary. Particularly, from what I understand, staying in the same practice for a couple of years for registrars who have families is really beneficial.
 
Dr Gerard Ingham
 
The uncertainty of joining a matching process and not being sure where you are going to end up. They are not employed under the national terms and conditions. Now, it is not the RACGP's role to tell practices how to employ or with their registrars because we are not an advisory, but it does strike me that it is unlikely that you could have a contract or arrangement because you can only be a contractor if you are an independent practitioner and if you are under supervision, it is fairly hard to make an argument that you are independent. Generally, there will be an employment contract. There are supervisor payments and fellowship support program. They are for the tasks being done, so there is a big front up payment to make sure that registrars start off safely for ten hours of work at the start of the term to do an early assessment, and then they get paid for reports and they get paid for their teaching at those rates, and the payments are plus GST and super. The next two programs we are talking about the PEP Specialist programs. PEP Specialists are for people who are already specialists at his GP, IMGs but international medical graduates where they have perhaps got their qualification overseas, and they have been that qualification perhaps they might be determined to be either substantially comparable or partially comparable. Substantially comparable for example, might be someone with a UK qualification as a GP and in that case they have a minimum six month program, maximum 12 months.

It is a shorter program. It is self-funded, again there is a large payment. They do not have to sit exams. They get fellowship after workplace-based assessments. Importantly, again an employment contract with the training post, but unlike the other two programs, the medical board APRA sets the supervisory requirements and unlike the other programs, there are no payments to the supervisor for providing that supervision. Just by comparison, the partially comparable is for people who have a partially comparable qualification. They have a longer program they are similarly self-funded, but they have to do the exams as well as completing the training requirements. Ditto to the fully comparable medical board set supervision and there are no payments. Other relevant programs which I am now moving away from are RACGP programs or run by RACGP programs, the Remote Vocational Training Scheme, which is a fully government funded and no diversity of practice requirement run by our organisation's been around for many, many years and has a fantastic reputation. People in this program are training towards either FRACGP or FACRRM.

This program is based upon remote supervision, so typically applies to doctors who are already in a town working as a GP but have not got the specialist qualification. They are already generally working at level 3 or 4 supervision. In other words, relatively independent practice, but there is no supervision in the town or in the region and they are having to get their supervisors remotely. For those of you who are becoming new supervisors, it is unlikely that you are going to become a new remote supervisor. By and large, remote supervisors are usually experienced supervisors who step up to doing it remotely. In this case, the supervisor cannot be the employer of the registrar. There is a very separate relationship and they are paid as I have listed there on the slide at basically $150 an hour. They are also in addition to those payments I put there where they are involved in supervisor professional development or their workshops, they are paid at the same rate.

There are other programs. There is the ACRRM Independent Pathway, which is, I suppose, the acronym version of FSP. The payments I have listed there, when I was an ACRRM Independent Pathway Supervisor, I did not receive any payments. I have not found any payments reference on their web page. I am not sure if there are. Other programs I want to mention, just that you could be a supervisor, return to practice as in a doctor who the medical board says, well, they need to have supervision while they are returning into practice. They set up the rules for that. That is not a very common one, and there are a number of legacy programs, as I mentioned before, with this dog's breakfast of training programs that we have. There are some programs that have been discontinued, but while the registrars are in those or the doctors are in those programs, they are continuing until their conclusion, but I have not gone into those. There you go. I have gone through all of that. You wonder with pace of all this complexity and the many hurdles, why do rural GP supervisors take on the role? If people could just type in the chat any ideas about why you would be interested?

Or why do you think supervisors are interested in this? I actually did an interview. This was my first big research project and I said, oh, we conducted a quantitative and qualitative analysis of interviews with 20 supervisors from Victoria and New South Wales. We have got some responses. People typed it in the Q&A, is that right or is that no responses.
 
Dimitri
 
My apologies. I think the chat is disabled. It should now be working.
 
Dr Gerard Ingham
 
Let us try and see if someone can chat. Why would you choose to be a supervisor? I have to learn all these programs, and do we have difference from what I have received? Yes. Sadly, I should not laugh really. It is often, sadly, the story, and that is my job is to try and improve the quality of supervision. That is my biggest responsibility, and sadly, I have to say, in order to train the next generation of doctors, that is actually great. Someone has tried to raise their hand, perhaps if we just type something in the chat and a way to attract doctors to rural areas. Beautiful answers. Okay. All right. I am going to show you what I found when we interviewed those and we shifted our way through all of the responses and did our thematic analysis, basically there people chose to do it for the personal and professional benefits of being a supervisor.

People have said it is actually a help them to keep up to date, and this constant questioning and reflecting upon practice they actually just found the variety of the work to be valuable for them, not spending all day and having collegiate discussions. They also, as was mentioned there by Mirinda, this responsibility to the profession of general practice, some of them was also acknowledged that there was often a benefit for the GP practice, often not so much a financial benefit, but just a sharing of the load of after hours and other such like, and there was a responsibility to the community both to provide a service at the time, but also into the future. We are altruistic bunch, are not we? Just seeing whether there are any questions in the Q&A at this time, Rod. Nothing there at the moment to answer.
 
What do supervisors do? This is the next section I am going to talk about. Basically, you can broadly think of it as three things you do when you are a supervisor. You have personal supervision. You are just looking after that person particularly. For those of you who have never been into general practice, they are often stunned at how exhausted they are or the challenge of being a supervisor and for many young doctors their first time with have actually taken professional responsibility for a patient's care, they might have been in hospital and everything up to that point has been run by someone else and suddenly the door closes and it is them and they have got to make the decision there, and then they find that quite tiring, and the rates of mental health problems amongst junior doctors are sadly the worst of all doctors. That is one part the personal supervision and an important part the clinical supervision is your absolute responsibility to that registrar is managing the patient safely. Is the patient safe? And we will talk briefly about things you do to do that, and then there is educational supervision, which you want them to be learning. That is a way of thinking of it.

More recently through other work that I have been involved with is we are moving towards developing a curriculum for the supervisor professional development program. We have identified ten roles. Some of those again are educational. Information providers are telling providing information. Learning enabler, that is more being a guide and facilitating questioning and demonstrated showing skills and procedures and communication skills, their education roles. You have then got the clinical overseer role there which is the patient safety, the advocate. You are a representative because obviously they are relatively powerless sometimes in the practice within the college, and you will often be an advocate for them. You are an advisory. They are asking you questions about their career and what to do, and reflectors, I see reflecting upon their learning and what they are doing, and you are also reflecting upon your own role as a supervisor. Coordinator and planner, both refer to coordinating within the practice and dealing with the RACGP or whoever the educational institution is and planner is planning the learning, making sure that they are getting the exposure to what they want, and then finally, of course, importantly, you are an Assessor. those are the ten roles that have been identified.

You will probably hopefully start to see those being demonstrated a bit more frequently if in future you are exposed to the supervisor role. What we do not expect? This is often people are reluctant to become a supervisor because they feel like, oh gee, imposter syndrome, I am not good enough. I do not know everything. I could not be an expert. In fact, we do not want experts. In fact, it is impossible. Let us just acknowledge it from the start. This kind of didactic teaching, which maybe that is what was being suggested before, was we do not want this idea that you have got all the expertise and you are pouring your knowledge into the brain of the registrar. We just help registrars to learn from the patients they see, to reflect upon their experiences and ask them questions and challenge them and help them to look away, look up things and reflect upon what ways to do it because often the answer to most things in general practice is in fact, it depends, and you spend a lot of your time talking about what are the factors which would make you decide one thing or another in a real life consultation, because that is what you bring your masters of dealing with the person in the room and making decisions in the context of the patient and they can never get that from a book or from anywhere else, and so that is your role. There is to be a guide on the side, not a wise person on the stage telling them what to do, but just a guide assisting them, asking questions probably, and that is to be honest, it is the most rewarding part of this job.

I mean, I had a teaching session yesterday and you know, that is just lovely to be asked. The registrar would ask me about starting antidepressants and they would read all this stuff and we just took them through a few scenarios and the kind of things that I think about and things I might talk about or why I might choose one antidepressant over another and that is all prefaced with the fact that it is one doctor's opinion, but that is still valuable for them to hear because it is turning theoretical knowledge into practical decision making. As I mentioned before, the important thing though, of course, is while we are ensuring the learning, we are also ensuring that they are safe. To do that, we make a fundamental idea is that there is a graded independence levels of supervision. We assess as we go. We do not do like this barber and say it is not that complicated, just give the man a haircut, it is not brain surgery and then lops off the skull.

We start with the presumption that they know very little and we observe and take notice, and as we become more confident in their ability, we entrust them in greater levels. At the start, you might be observing in the first week you may actually be sitting in or week or two even, you might be observing every consultation or coming in at the end of every consultation, or getting a phone call at the end of every consultation. That is called level one supervision currently, and then you may progress ultimately to level three supervision where the registrar determines when they would call you in, those kinds of graded levels, and you do that through this observation. You also, once you are no longer reviewing every patient. You usually conduct some kinds of audits of their activity. You open up all their notes and discuss the selection with them. That is called random case analysis, and you will also have a series of assessments which you are required to complete, which usually involve sitting in and observing or reviewing registrar notes or discussing their cases. We use those assessments also to help you reflect upon the supervision plan that you have for the registrar.

In terms of the requirements for supervisors, in all programs, supervisors have to have at least specialist general practice recognition, preferably having fellowship, but if not having specialist recognition as a GP with APRA. You have to have unconditional registration and be of good standing. Several years experience is preferable, but not mandatory. You can actually become a supervisor in circumstances fairly much quite soon after getting your fellowship, if that is on an individual basis decision is made. Importantly, you need to have no conflict of interest with the registrar. A personal or a family relationship with The registrar is not allowed. In the RACGP programs, we believe that supervisors need to have education to become a supervisor. These skills are not the same as just being a doctor. It is not a case of see one, do one, teach one. There is a bit more to it than that. We require that you complete an education program and also we have the absolute vital importance of cultural safety. Cultural safety is clinical safety. We want to be aware that supervisors at least have cultural awareness education within the previous three years.

We aim to embed further cultural safety education within the foundations program. You will never get there. You are always learning in this area. There are some differences between the programs. There are differing assessments and teaching requirements and if you are in one program, you are reporting through one portal and another program reporting through another portal. Unfortunately, as I mentioned right at the start, that part is quite complex. The RACGP has some guides to help you with Supervision at a Glance Guides and we have handbooks and we will assist you with that, but there is a little bit of learning to do with that. The important thing with the two prime RACGP programs, AGPT and FSP, they have fundamentally the same supervision requirements. If you can meet these, there is no questions asked requirements. If you cannot meet these, you have to get some prior approval or we need to be aware of them. It is not to say they would not be allowed, but just it is all individualised. We also understand that in rural and remote areas, often things need to be modified, particularly if there is a registrar who is going to be capable and the supervisor is available and approachable that other things may be approved.

Fundamentally, the expectation is during the first few weeks, there is an accredited supervisor and they are on site 100% of the time, and they review every consult. During the first year, an accredited supervisor is on site 80% of the time and able to attend the remaining 20% of the time, the registrars consulting. During the second year, an accredited supervisor is available 80% of the time, but you can have the remaining 20% of the time covered by someone else who is a specialist GP but is not an accredited supervisor. In this second year, you only need the supervisor on site 50% of the time. As I mentioned, any other arrangements need prior approval. Anything you want to say about that, Rod, in the FSP space?
 
Dr Rod Omond
 
Nothing in particular about that. The FSP struggles because there are less resources because there is less money. We have to get all the money from the registrars. We are really trying to match the requirements for supervisors between both programs. Hopefully, it will be possible to move backwards and forwards, and there is a little bit of leeway with the Department of Health now. It should be possible that we can use some educational material to teach both groups. There is a little window opening up that the government is allowing even though they do not supply any money. There was a question about the foundations program.
 
Dr Gerard Ingham
 
Yeah, I am going to come into that, Rod, in a second. It is a bit further on. When you run it, Rod, it is run differently in every state and also run by FSP run nationally. When you run it, it is four webinars done over how many weeks?
 
Dr Rod Omond
 
Four webinars, and you have to do a total of four GP learning sessions as well, as part of that.
 
Dr Gerard Ingham
 
The webinar is about an hour, an hour and a half? It is over in a couple of months or something? It is about a 10 to 12-hour commitment over that time, including your reading and other material. That was the question. There is a big change coming down the pipeline in 2026, which is that all training in RACGP monitored programs that is both AGPT and FSP must occur in practices that are already accredited. Up to this point in FSP, people could start and get accredited later, and we have recognised that that really was not ideal. Now we want all practices to be accredited before they start having a registrar.

If you are becoming interested, and obviously attending the webinar tonight might suggest that you are, there is an expression of interest open and it must be submitted no later than 4 o'clock on Tuesday, 12 August. I do not know if you have got the opportunity there, Dimitri, to put the link into the chat would be quite handy for people. If you can find that up there. If you do not get it in time, but you still got through the expression of interest and met eligibility criteria, then you would be held over for the following term. There is the page. I put the address there, but that is not thorough a link. I am sorry, Dmitri. That is the address there. I am sure if you just typed in an expression of interest in training program, your search engine should take you to that. That is important to know.
 
Dimitri
 
I have just put that in the chat there.
 
Dr Gerard Ingham
 
Lovely, so people want to link off to it and start to think about that and save it. As I mentioned before, I am going to talk about the foundations program. The word doctor comes from the same origin, doctrine to teach, although you spend a lot of your time teaching patients and we think there is a bit more to it than that. It is the skills as an educator which are related. There is probably an overlap between being an educator and a clinician. You need both skills to be a competent GP supervisor. Up until now, we have not been able to use the flexible funds from the government for all new supervisors getting ready for FSP. We have now recently had determination from the government that we can use the flexible funds for all new supervisors because we are now deciding we are accrediting all practices to be ready to take either AGPT or FSP, and because of that, we are now able to fund supervisors for completing the foundations program. As I mentioned, it is up to 12 hours. It is usually 10 hours initially because there are first seven modules. The eighth module is an optional module where you get to submit a video of yourself teaching, which is not compulsory currently. You get paid at $150 per hour for your attendance.

Previously it was possible people could do it entirely online via GP learning, but from 2026 or for the remainder of this year, it is going to become a requirement that you complete some of the modules online on GP learning. Complete three of them that way, but you may have to do the other four either via a webinar or via a face-to-face attendance. How it is actually delivered will depend on where you are and what is being run. I would not start logging onto GP learning. If you can start going through any of those, you need to wait until you have been accepted and then find out how the program has been delivered in your region. That is just for your interest. The ones in yellow are the ones which are the ones which are delivered via webinar or face-to-face experience. The other ones are a bit more text heavy, and you can just read through them and then ask questions when you come to the workshop.

In terms of what support do we provide. The RACGP, on the web page there, there are some key training contacts generally supported depending on the program by training coordinators and medical educators. Importantly, there is also supervisor liaison officers. They are vital supports, particularly if there are any educational issues, particularly with your registrar more from the industrial and other kinds of support. There is from GPSA who also have excellent suite of educational resources, fantastic material. They are available for supervisors to reflect upon and to help you in your role of becoming a supervisor. I would also finally say with that support, the other great support is actually talking to other people who do it. Other training practices in your region. When I first started out as a supervisor, there was often competition. More and more just realised we had so much to learn from each other and working with each other.

I have even had circumstances where that diversity of practice requirement, we have had registrars go from our practice to another practice and we take ours and we will take yours kind of arrangements and working together. One of the things that does happen when you start getting involved in supervisor professional development, you come to meetings and you meet a collegiate group of people who, as I mentioned earlier, have these altruistic goals about education and trying to improve general practice for Australia. It is lovely to meet and spend time with people. I am just checking if there are any other questions in the Q&A. It is going to be a speedy webinar unless someone puts up some further questions or things you want to say.
 
Dr Rod Omond
 
I will be doing an introduction for FSP supervisors next Thursday night. If you want to attend that, just ask using that inbox ruraul@racgp.org.au and either Jessica or Dmitri will get you an invitation.
 
Dr Gerard Ingham
 
Foundations or is it just an introduction?
 
Dr Rod Omond
 
No, that is just an introductory one. I do the foundations course, at the moment I am doing it after the registrars have started because that has been our pattern. We do not know who they are until the registrars start, but that will change later this year, I assume.
 
Dr Gerard Ingham
 
It will. Yeah, we are planning to make a change, Rod. More work for you. The thing to say, of course, it is this huge uplift, which the RACGP is getting ready for, and the election was announced, there is increased training places in AGPT. The FSP is like a magic pudding, it is not at the moment, Rod.
 
Dr Rod Omond
 
We have got 30 odd registrars, we will have over a 1000 after the next intake and probably about 1200 by next year.
 
Dr Gerard Ingham
 
We obviously have a great need to increase our number of supervisors and to increase the number of training practices and to provide that education. We are going to be delivering a lot more foundations and figuring out how to do that, which is a great thing. One of the wonderful things there now is around the country, we have a nationally consistent introduction to GP supervision delivered by the RACGP.
 
Dr Rod Omond
 
Now there is a question in the Q&A. If there are many supervisors in a practice, is the payment for each supervisor? Now FSP does it by having a primary supervisor who gets the money. If other people help out, you sort it out amongst yourselves in the practice, but there is one primary supervisor who is the one who gets paid by FSP for those payments that we are talking about.
 
Dr Gerard Ingham
 
That is an FSP, and the other main program, which is the Australian General Practice Training Program. As I said earlier on where we go back to there is a certain payment, the nationally consistent payment and they actually go to the practice. As I put in the asterisks there, it is expected the practices distribute the teaching payment. Again, this was the government's determined way, the national consistent payment. They just said that is the way we are going to do it. We are not going to be paying individual supervisors. I mean, I can understand why they would have said "oh, so-and-so is doing 93% and so-and-so is doing 5%. Can you split it up this way?" They find it easier to pay to the practices.

All those issues relating to payroll tax, etc, etc related to that form of payment. That is what it is currently. Any other Q&A? Is the supervision different to supervising IMG on provisional registration? If a doctor has got provisional registration, but if they are not under AHPRA on supervision then they do not need supervision. Is that right?
 
Dr Rod Omond
 
It only takes level 2 AHPRA supervision and above. We do not have any registrars who are in level 1 AHPRA required supervision.
 
Dr Gerard Ingham
 
Again, in FSP, all the registrars are on provisional or limited area of need of supervision. Is that right?
 
Dr Rod Omond
 
Some are on provisional. There is variation.
 
Dr Gerard Ingham
 
Apologies for me getting that mixed up. I am just going to go back over this to try to fix up the dog's breakfast in my explanation. The level of supervision will depend upon the relevant training program that you are in and the position of the AHPRA. In AGPT, the AHPRA does not set the terms of supervision. The terms of supervision are set entirely by the supervisor. The degraded level of supervision that I have discussed in FSP, Rod as you are saying, sometimes some registrars do have a medical board determined level of supervision.
 
Dr Rod Omond
 
Yes. That is correct, and their FSP supervisor has to be a recognised supervisor by AHPRA. The two have to be the same. That is that is what we have set as our standard.
 
Dr Gerard Ingham
 
Okay. So that is in the two programs and in other programs such as the PEP specialist comparable or substantially comparable, the supervision requirements are set by AHPRA.
 
Dr Rod Omond
 
A question can from Mustafa. Can RACGP supervisor supervise ACRRM Registrars? Yes. We have actually managed to agree on that, which is amazing, but yes.
 
Dr Gerard Ingham
 
Yesterday, I was having a teaching session with four ACRRM registrars and one RACGP registrar was a group teaching session in my practice. That is definitely possible. The aim is to have joint accreditation. There are some supervisors who choose to be supervisors just with one college or the other, and that is entirely allowed. If you are an RACGP supervisor, ACRRM will generally accept your teaching.
 
Dr Rod Omond
 
Yeah, and FSP allows ACRRM Fellows to be supervisors as well. Being a rural program would be a bit silly, if we did not.
 
Dr Gerard Ingham
 
I would have thought so. Yeah. As I said, though, we will have the requirement and are making it a requirement that they have to complete the foundations program, which ACRRM currently have a different foundations program which is a bit briefer than ours. It is not currently the RACGP policy to accept that as equivalent to our preparation program. Any other questions? All right. In summary, we have a complex system of training program. The core work of a supervisor is the same in all of those programs, ensuring the patients are safe, the registrar is being looked after and the registrar is learning. Sadly, the remuneration and requirements are not. It is complex. Now is the time to submit an expression of interest for AGPT or FSP training. The RACGP Foundation Program is required to be completed and is likely to be funded for all new supervisors from 2026.
 
Dmitri
 
Fantastic. Thanks, Gerard. I might just talk briefly on this slide, but before I do that, I just want to thank yourself, Gerard, and Rod for sharing your insights and your experiences on this very important topic. If anyone does have any questions for Gerard or Rod after the webinar, feel free to email me and I will pass those questions on.
 
Dr Gerard Ingham
 
My email, gerard.ingham@racgp.org.au. I am happy also to receive anything directly.
 
Dr Rod Omond
 
I am rodney.omond@racgp.org.au.
 
Dimitri
 
Thank you so much. A reminder to please complete the evaluation once the webinar ends. It will only take a couple of minutes and it will give us a better idea on how we delivered today and future improvements as well. For all RACGP members, you will receive your CPD hours and a certificate or a statement of attendance will become available on your CPD dashboard. If you want to check back in just a few days, that will be available. For any non-RACGP members, who would like a certificate, please email me directly and I will get one sent out to you.

Lastly, I would like to invite everyone that has joined us this evening to attend our part 2 of this webinar series on how rural registrars can attract registrars which will be held on Thursday, 3 July at 7 o'clock eastern time, and we will look at exploring key strategies rural supervisors can use to recruit and retain registrars. Dr Michael Clements will be presenting and he will be sharing his practical tips on attracting registrars, addressing common challenges, and of course, showcasing the unique benefits of why to go rural. You can do a quick QR scan. I will also pop just in the chat a link there for you to register. It is, of course, free as well.
 
Dr Rod Omond
 
There is one question in the Q&A. Michael works in Wide Bay, and who should he contact in that part of Queensland to make registrars interested to train in the area? Interesting question.
 
Dr Gerard Ingham
 
Is it already a supervisor or already a training practice? If you are already a training practice, then you would be going through either the AGPT or FSP teams. If you are not, then the first step is to register interest. We are going to see this big uplift in the number of people. We have had an increase in number of applications to AGPT. We have got increasing places. Over the years of having been in this game for about 30 years, there has been times where it has looked good and times where it has looked less good. I am a little bit confident for the next bit. In terms of contacting someone specifically, would that be fair to say, Rod, if you want to become a training practice and express an interest?
 
Dr Rod Omond
 
Yes. For FSP, we do not advertise for registrars as such. They find us. Within the college, we do not have an option. I mean, obviously, registrars find jobs, so the employment agency locally would be the option there for FSP.
 
Dr Gerard Ingham
 
For AGPT, the requirement of AGPT is that 50% of training has to happen in rural placements. That is a requirement. The federal government, along with the RACGP, have been looking at incentivised placements and improving the incentives to ensure that we do get registrars out to where they are really needed. There is a complex strategy that I am not across all the detail, but there are series of incentives and restrictions that apply to try to get registrars out to where they are needed.
 
Dimitri
 
Fantastic. Thank you so much, everyone. We might finish now a little bit earlier than planned, but all good. Thank you so much for that great little introduction. I am happy to share the presentation with everyone that has attended. Look out for that in your inboxes tomorrow.
 
Dr Gerard Ingham
 
Thank you very much, all and have a good evening.
 
Dr Rod Omond
 
Thank you everyone.
 
 
 
 

Other RACGP online events

Originally recorded:

12 June 2025

This instalment of the Rural Health Webinar Series will provide an introduction on the benefits and essential steps involved in becoming a supervisor in a rural setting. Join Dr Gerard Ingham and Dr Rod Omond as they explore the role of a supervisor, the positive impact you can have, and a clear roadmap to getting started. You’ll learn about the importance of the supervisor role, how it contributes to the development of the rural GP workforce, and why it is such a fulfilling and vital position in our rural communities.

Learning outcomes

  1. Understand the role of a supervisor in a rural general practice setting.
  2. Identify the benefits of becoming a supervisor.
  3. Navigate the initial steps to becoming a supervisor.
  4. Identify available support systems and resources for new supervisors.

This event is part of Rural Health Webinar Series. Events in this series are:

Presenters

Dr Rodney Omond

Dr Rod Omond currently works for Top End Primary Care as a DMO, after working for them for eight years in Darwin. He does regular locums in the NT in remote communities. He is Chair of the NT DoH Prevocational Accreditation Committee which conducts accreditation of prevocational medical training in NT hospitals. In addition he is a board member of RVTS, and a clinical advisor for Point of Care Testing (POCT) in remote communities. This is also his area of research. Rod’s second area of work is as a Clinical Educator with RACGP, for the PEP Program. He is a member of the RACGP Rural ±«ÓãÊÓÆµ Committee.

Dr Gerard Ingham

Gerard Ingham is a rural GP and GP supervisor in Daylesford, Victoria. He has been involved in the supervision of over 100 RACGP and ACRRM registrars. Dr Ingham has also worked as a Medical Educator for 30 years with a focus on the education of GP supervisors.

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