AUGUST 2013 - New Zealand Doctor

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RNZCGP Review of the delivery of general practice vocational training August 2013Future training• more technologically savvy and more comfortable using online self-service channels and usingsocial media to interact with their peers;• comfortable with on-the-job, team-based learning and learning in a small group environment;• location immobile and expect that they can work and train in locations that are in close proximityof each other, or use technology to ‘close the distance’;• frequently changing their place of work, practice environment and/or their role within theirpractice;• able to make their own choices about their work and training locations and hours; and• providing a higher level of care within the community.The GP teachers of the future are likely to:• be aging, meaning for the next 10 years the age gap between the GP registrar and the GPteacher will grow. By 2020 there may be a shortage of GP teachers/supervisors as GPs retire;• have greater demands on their time, as a shortage of GPs will require GPs to manage a greaternumber of patients;• be increasingly female, as male teachers/supervisors retire. Depending on the number of femaleGPs who work part-time, the pool of potential teachers/supervisors may be further reduced, or theavailability of these teachers/supervisors may be reduced;• share teaching/supervision responsibilities with others; and• demand greater professional development.The GP practices of the future are likely to:• be owned by a group of professionals, who may, or may not, be doctors;• employ a wider range and larger number of healthcare professionals, including doctors;• provide better opportunities for peer review and support;• have reduced on-call and after hours work; and• deliver higher scope procedures.The College has developed forward-looking propositions which it believes will ensure that the GPtraining programme is fit for purpose for the GP of the future. These are outlined below.Pre-vocation trainingIn New Zealand, PGY1 and PGY2 training is completed in a hospital without any, or minimal, inputfrom or contact with GPs or the College. On the other hand, PGY1/2 interns are interacting withspecialists on a daily basis and seeing, or hearing about, the ‘cutting edge’ developments beingmade.18
RNZCGP Review of the delivery of general practice vocational training August 2013The 2011 survey by the New Zealand Medical Association (NZMA) showed that the average time fortrainees to decide on a career choice was three years after graduation. By the end of PGY2, 44% oftrainees had decided on a vocational training programme, 78% by the end of PGY4, and 13% tookmore than six years to decide.The same survey showed a very different picture for general practice, with trainees who decide toenter the GPEP programme doing so much later. For example 97% of general surgery registrars hadmade the decision to enter that training programme by PGY4. By comparison, only 58% of GPEPregistrars had made the decision to enter the GPEP training programme by PGY4.If the College is to increase the profile of a career pathway in general practice, more interaction isrequired between the College and the PGY1/2 interns. To achieve this, the College and the DHBsneed a more structured relationship which allows the College access to PGY1/2 doctors.The proposed introduction of community based training in PGY1/2 will expose more interns to generalpractice, however there will be greater pressure placed on limited general practice training positionsand teachers.19
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AUGUST 2013 - New Zealand Doctor

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