About PGPPP > Frequently Asked Questions - Practices & Supervisors

Frequently Asked Questions - Practices & Supervisors

How long is a PGPPP placement?

In NSW and the ACT, PGPPP placement terms are consistent with hospital rotations which are ten weeks long.

What are the hours for a fulltime placement?

Hours for a fulltime placement differ between interns and PGY2 and depending on the location of the post. Interns work a normal working week as defined by the feeder hospital. PGY2 (Rural): Normal work hours vary between 41 and 45 hours with the latter including a weekend (Saturday Morning) in Practice. These normal hours include 2-6 hours of overtime. In 2011, Bowral-based posts will not include mid-week on call work but PGY2s will do weekend working Bowral Emergency Department with supervision provided by the AHS. A similar arrangement may eventuate for the Shoalhaven, pending appropriate hospital term accreditation.

What about after hours work?

Rural PGPPP posts would include funded hospital rostered overtime and hospital call back components. Typically a PGY2 doing a weekend on call would work 4 hours of rostered overtime (1800hrs - 2200hrs) per week plus required hospital call back hours. A PGY2 working a weeknight and weekend on call would do 6 hours of hospital rostered overtime per week plus require hospital call back hours. NSW IMET requires that the Supervisor be called for each PGY2/3 hospital call back, until at least the fifth week of the term from which point supervision is at the discretion of the Supervisor.

More information about the breakdown of a rural PGY2's hours for an existing rural post can be found in the Information Pack for Practices & Supervisors.

What educational support should the Practice provide?

NSW IMET standards are currently being developed for the 2011 program. In CCCGPT's PGPPP posts, the structure of educational support programs differs between PGY2/3 and Intern posts in terms of who takes responsibility for delivering education. Common to all posts is the need for 1 hour of protected teaching time weekly, in addition to the supervision requirement discussed below. Common elements include that practices are required to provide an orientation at the beginning of the placement and Supervisors are required to help develop a learning plan. As with Registrar education, structured sessions may take a variety of forms including case discussions, work shadowing, practical skills sessions, meetings, tutorials, video consultations and review. Practices are encouraged to conduct integrated Registrar/PGPP/Student Education sessions with the delivery of the session being shared between Supervisors, Registrars and other Practice staff as befits the culture of the practice. In 2011 IMET's standards will require that the appointed supervisor be accredited by the RACGP or ACRRM, though otherr doctors participating in the teaching program need not have this level of accreditation.

How does CCCGPT support and contribute to the Education Program?

Interns

CCCGPT develops and manages an in-depth induction program (conducted in the first week of the term) and thereafter coordinates an intensive weekly educational program undertaken in the practice by a range of Medical Educators, Academic GP Registrarsm Division and other staff.

The CCCGPT model removes pressure from the Supervisor leaving time to concentrate on the supervision requirement.

PGY2/3

IMET Standards will require that a CCCGPT Medical Educator be appointed as mentor to each JMO undertaking PGPPP terms. In addition to mentoring/supporting as required, the mentor will work with the JMO to develop an intial learning plan and discuss the challenges of General Practice relative to hospital based medicine. Additional Medical Educators will also conduct ECT visits (one per rotation) and JMOs will have the option to attend Registrar educational events.

What is the Supervision requirement for Interns and PGY2/3s in General Practice?

Interns

The PGPPP Doctor consults the Supervisor about the management of all patients. The Supervisor takes primary responsibility for individual patients and the PGY1 Doctor takes limited responsibility. The Supervisor must be physically present or available within 10 minutes to provide physical review at any place where the PGPPP doctor provides care.

PGY2/3s

The PGPPP doctor must consult the Supervisor about the management of patients at a frequency determined by the Supervisor and the PGPPP Doctor. The Supervisor hsares responsibility for individual patients with the PGPPP doctor.

The structure and frequency of Consultations for Interns

Interns can see two patients an hour, with the Sueprvisor being called into the consultation once the history has been taken and the Doctor's actions are ready to be checked and signed off. Feedback indicates that developing an approach to managing the interruption of their own consultations to meet intern supervision requirement is initially the most challenging taks for Supervisors, and that approach may vary depending on indivudal consulting stypes and the receptiveness of patients.

Given the intensity of the supervision requirement for interns, it is recommended that the Practice use multiple supervisors. Click here for more information about the WAVE Consulting Model.

A sample weekly roster is provided in the Information Pack for Supervisors & Practices.

The Structure and Frquency of Consultations for PGY2/3

The number of patients seen by PGY2/3s will depend on the Supervisor's assessment of each doctor's capabilities. To begin with, the expectation is 2-3 patients per hour increasing to no more than 4 per hour during the term - and always at the Supervisor's discretion. The PGY2/3's patients do not require sign off by the Supervisor.

A smaple weekly roster for PGY2/3s is available in the Information Pack for Practices & Supervisors.

Can PGPPP be set up in any Practice?

It is CCCGPT policy that a practice must have a track record of experience in supporting GPT1 and GPT2 Registrars and/or long term medical students.

What are the additional accreditation requirements?

ACT and NSW practices must be accredited by IMET. In other words, your practice is accredited in the same way as any other hospital term. The paperwork for accreditation has been simplified and tailored to the general practice setting. Based on statisfactory completion of paperwork and attendance at a joint meeting with IMET and CCCGPT your practice will receive interim accreditation. After three JMO rotations in terms a site visit will take place with a view to your practice transitioning from provisional to full accreditation.

Can you opt in and out or are you contracted for a certain amount of terms?

Practices are contracted for the number of terms specified in their application on an annual basis. For some practices, this might be all five terms in a year, while for others, rotations in terms 2, 3 and 4 might be practical. Once contracted, the expectation is that you would not opt out before the end of the calendar year.

Are consultations billed to Medicare?

Interns

No, the feeder hospital contiues to pay the Doctor's salary.

PGY2/3s

Yes. Consultations are billed to Medicare using the provider number of the Junior Doctor.

How are PGY2/3s paid?

The PGY2/3 remains an employee of their feeder hospital and coninues to be paid and accrue leave entitlements etc from their hospital. Because the Junior Doctor comes to the Practice with their salary paid by the hospital, the PGPPP process requires that Medicare billings to cover salary plus on costs be paid to the AHS. CCCGPT will invoice the practice and facilitate these payments.

Practices will be required to provide CCCGPT with the Medicare Billing data for each rotation. In 3 years of operation have never been out of pocket using this process.

How is the Practice Paid?

Practices are paid set amounts to cover supervision, briefing and orientation costs and a further amount for infrastructure development. Within two weeks of the completion of the 10 week rotation, the practice is invited to submit an invoice to CCCGPT for the contracted amount which will vary for PGY2/3s vs Interns and between rural and urban locations.

Payments to practices include the following per 10 week rotation:

Supervision and Teaching: $7,200
Infrastructure and Support: $5,800
Briefing and Orientation: $1,000
Total per 10 weeksL $14,000

The Practice hosting the PGY2/3 also retains any billings above that repadi to the AHS and keeps all private billings earned.

What is the financial impact of a PGPPP post on the Practce?

To estimate the financial impact of a PGPPP pst on your Practice, Supervisors and Practice Managers can log into CCCCGPT's GPRime system and use the "PGPPP Ready Reckoner". An example of this ready reckoner for a PGY2 seeing 2.5 patients per hour is provided in the Information Pack for Practices & Supervisors.