AUGUST 2013 - New Zealand Doctor

RNZCGP Review of the delivery of general practice vocational training August 2013FUTURE STATE OF GP TRAININGIN NEW ZEALANDThis section of the TDR consultation document examines the trends that will determined the GPtraining environment in the future and the dynamics that will influence the models of training. It alsoexplores the likely profiles of registrars, teachers and practices as they evolve over the next 10-15years.IntroductionGP training in New Zealand must change to align with the required skill sets and workingenvironments of doctors who will be GPs in 2020 and beyond. To ensure that the College develops atraining programme suitable for the GPs of the future, a number of guiding principles were identified.• The patient experience of care when a doctor is in training should not jeopardise their health care,however doctor training should be primarily experience-based.• Doctors need to be trained to work in a variety of settings, hence they must be trained in thosesettings, i.e. aged care facilities, as well as gaining experience with more vulnerable populationssuch as Māori and Pacific Island groups.• Training must reflect team-based work environments.• Ensuring that GPs have training which reflects the patients they will be treating and thetreatments they will be providing.• Working to increase the number of practicing GPs in New Zealand.• Equality, both financial and educationally, with other training schemes, allowing for the uniqueenvironment of GP training.Future trendsAs the population of New Zealand ages, not only does the care required by this population changebut so too does the age of the doctors treating them. The New Zealand Medical Workforce in 2011report identified that, on average, New Zealand has 75 GP full time equivalents (FTE) per 100,000people, but a number of regions have less than 64. The age structure of the current GP workforce isexpected to show an increase in average age, followed by a high proportion of these GPs retiring in2020/2025. The tagging of health training money to vocational training programmes from PGY3, andincreasing amounts of secondary level health care being provided in community based settings, willhave an impact on the training required by GPs in the future.The GP registrars of the future are likely to be:• 60% or more female, although the number of male GP registrars is increasing;• younger, a result of increased funding tagged to vocational training and doctors being encouragedto decide on their vocational scope earlier. This lowering of the average age of commencementin GPEP Year 1 may reduce the number of registrars being involved in parenting during theirtraining;17