RACGP CEO answers questions on exams, remuneration and more

Newly appointed RACGP CEO Dr Matthew Miles recently sat down with the Registrar Representative on the RACGP Board Dr Kystyna de Lange to provide an update on the college and several key issues, including exams, remuneration and rural workforce shortages.
 
Dr Miles revealed that the Board has recently approved the its Strategic Plan, which will set the direction of the college for the coming years, and that the key priorities will be increasing advocacy work and ensuring the RACGP is a member-centric organisation.
 
He went on to address the recent issues and subsequent cancellation of the Key Feature Problem (KFP) exam and Applied Knowledge Test (AKT), before answering specific member questions.
 
Exam outage
Dr Miles expressed the college’s ‘deep regret’ over having to cancel the exams, and explained what the RACGP has done and is continuing to do to help all those affected.
 
‘Though [it was] a necessary thing to do and the right thing to do, it was really disrupting and problematic for people and we fully understand the sacrifice that our candidates go through to get themselves to these exams,’ he said.
 
‘There’s been an absolute mountain of work that’s gone into rectifying and remedying the situation … hundreds of individual meetings, [and] there’s been two additional Board meetings where we’ve really come up with solutions and prioritisation of those solutions, so we can deal with the problems in real time.
 
‘Some people have already started to get refunds and there’ll be some systems in which a refund will be quite quick – for example, if it was just on a simple credit card – and there’ll be other systems of payment that it might take a little bit longer.
 
‘Obviously there’ll be the opportunity to resit the exam within the next 18 months and that if there was any problems with anyone failing that exam that wouldn’t contribute to the examination cap.
 
Dr Miles assured candidates who are due to sit the upcoming Remote Clinical Exam (RCE) that it will be hosted on a different platform. He also said the college is prioritising efforts to support candidates who have any issues with visas or the Department of Home Affairs.
 
Registrar remuneration
Dr Miles said while remuneration for all GPs is an issue that ‘needs to be addressed’ and is ‘front of mind’ during conversations with health department officials in Canberra, registrar remuneration is important due to its impact on attracting the next generation of GPs.
 
He suggested increased base pay for first-year registrars as an example of a potential remedy that is already being explored, but said there are ongoing discussions about a range of different options.
 
‘We’ve also been talking a lot about more portable employee conditions or elements of that nature, where that can really help with remuneration and some of the things that go along with remuneration,’ he said.
 
‘The other main item is also around some of these trials that are going on within the single employer model and just seeing whether that is something that may be useful to help rectify some of the [issues] that we’re seeing with remuneration of our registrars.’
 
Training
Dr Miles said it is clear fewer candidates are applying through the Australian General Practice Training (AGPT) system and that it is a ‘real area of concern’ for both the RACGP and the Department of Health.
 
‘This has really been one of those key areas that I’ve been working on,’ he said. ‘We were working towards a system utilising the RTOs [Regional Training Organisations]. The [Health] Minister mentioned and announced the return of training to the college and so we’ve been working towards that system.
 
‘There definitely has been a change in their thought process so, given that, we’ve been working really, really strongly with the Department [of Health] and trying to understand the model that we’ll take forward to deliver training into the future.
 
‘We don’t have all the clarity and all the information right at this very moment, but we are still working very, very hard with them to identify exactly what the Government wants to try and achieve and how can we be part of that solution.’
 
A top priority during these negotiations, Dr Miles said, is to avoid any disruption for GPs in training.
 
‘We don’t want any disruption to the system and we want to be able to be clear on what the implications might be for change,’ he said.
 
‘The Government itself is clearly trying to look at some ideas where the workforce distribution could be improved, particularly into the rural areas, and I think it’s fair and just for them to want to be able to do that. We want to be part of that solution and we will be part of that solution.
 
‘The RACGP, its rural faculty, its ability to have such a strong position in rural and remote Australia and the fact that so many of our members are rural practitioners, holds us in really good stead for that conversation, and so the Government is really coming to us and asking our opinion on how that can be achieved.
 
‘Within the next couple of weeks we’re going to have a much clearer picture of exactly how that system will work and what will be the role of each entity.’

Workforce distribution issues
Rural workforce shortages were addressed in further detail during the Q&A, with one regionally-based GP asking what the college is doing to help rural practices attract practitioners, particularly those that aren’t classified as an ‘area of need’.
 
Dr Miles said encouraging more doctors to practice rurally is a key component of the Strategic Plan, and is a ‘clear topic of conversation’ at every meeting with Federal Health Minister Greg Hunt and Regional Health Minister Mark Coulton.
 
‘Rural workforce is one of Minister Hunt’s clear goals to improve, that it’s one of the clear goals of the Department [of health] to try and find solutions,’ he said.
 
‘We’ve talked a lot about the Rural Generalist Pathway, for example, as a part solution to this issue. I know that there are other trials and other things going on in different parts of the country that will help identify whether these are really going to help the system.
 
‘We [also] try and do as much as we can at the RACGP just with our website, such as the recruitGP website, to make sure that people have avenues to be able to recruit general practitioners to their practice.
 
‘Obviously there’s also the work that’s going on through our IMGs and through the PEP pathway, which is important for getting doctors to be able to provide those placements for rural needs.
 
‘This is really about putting forth achievable solutions within a certain timeframe because it has gone on for a long, long time and there’s very, very clear evidence that we haven’t really made a great impact on this.
 
‘I think that needs to be clearly stated, that we haven’t made a great impact on rural health workforce distribution and so we need to be looking at some of these more innovative ways that we can do so.’
 
General practice funding
The delayed 2020–21 Federal Budget did not include much in the way of additional primary care funding, but Dr Miles said the college’s work on the RACGP Vision for general practice and a sustainable healthcare system is beginning to pay dividends and that he is hopeful of a better outcome in future.
 
‘The Government really likes that work and they like the fact that we can take bits out of [the Vision] and look at what are some of those real key issues that we need to deal with and prioritise, and then provide them with implementation plans for achieving those goals,’ he said.
 
‘There was a little bit of disappointment with this recent budget that there wasn’t a lot of items relating to that. That wasn’t necessarily a surprise to the RACGP, but we’re going to be looking very, very closely and working very, very hard for the next budget.
 
‘We’ve got two budgets very, very close together given the very strange circumstances which we’re living in, so we’ll be really pushing very, very hard that GPs and primary healthcare has a front and centre position in that budget.
 
Aside from funding, Dr Miles said there are other ways that the college can help GPs struggling with the financial aspects of general practice.
 
‘There’s a later question as well around … what can we do to make sure that we can provide opportunities for our GPs to maybe reduce their expenditure, for example, which has a net position, which is positive for our key primary healthcare providers in Australia,’ he said.
 
‘The Vision … I think is really, really important from the RACGP’s perspective and if we can build out a lot of those implementation plans for the Government, they love being able to have that in a very simple, one or two pages that they can then think about how they could fund and then how they could announce.’

The RACGP has scheduled a ‘KFP and AKT candidate Q&A’ to be made available on Monday 2 November. Members are invited to send in questions and feedback about the cancellation of the KFP and AKT, with responses provided by a panel featuring CEO Matthew Miles and members of the RACGP Board and Executive.
 
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