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The Royal Australian College of General Practitioners

1. POLICY TITLE ASSESSMENT OF OVERSEAS GENERAL PRACTICE


EXPERIENCE AND AUSTRALIAN GENERAL PRACTICE
EXPERIENCE

1.1 Policy number: AS-E-022.0


1.2 Category: Organisational
1.3 Approval date:
1.4 Revision due date: May 2013
1.5 Unit responsible Assessment

2. POLICY DECLARATION

This policy defines assessment of Overseas General Practice Experience and Australian General
Practice Experience to enable the RACGP to determine a prospective Practice Eligible assessment
candidate’s eligibility to participate in one of the College’s pathways to Fellowship. Applications for
assessment of general practice experience will be assessed in the context of the definitions of general
practice as set out in this policy.

This policy is approval by Council and authorisation by the CEO.

3. BACKGROUND

i) Objectives

The objectives of this policy are to:

• Define assessable general practice experience for applicants wanting to attain


Fellowship of the College via the Practice Eligible route
• Provide guidelines for applicants preparing an application for the assessment of
Overseas General Practice experience and/or Australian General Practice experience
• Recognise the variety of settings in which general practice experience can be gained

The intention of this policy is to set out the rules for assessment of general practice experience to the
standard required for eligibility to participate in any of the College’s assessments that culminate in the
award of Fellowship. This policy ensures that the College maintains appropriate standards for
determining eligibility, whilst recognising alternative pathways to Fellowship.

ii) Specific Aims

The specific aims of this policy are to:

• Inform applicants, applying through the practice eligible route, of the requirement for a
general practice experience assessment to determine eligibility to participate in any of
the College assessments.
• Provide a comparable set of requirements of general practice experiences that meet the
standards for eligibility to participate in any of the College assessments.

3.1 Related documents

“Standards for General Practice Education and Training Requirements for Fellowship 2005” available
to view at: http://www.racgp.org.au/fellowship

“Academic Misconduct” available at: http://www.racgp.org.au/assessment/policy

ID number: AS-E-022.0 Page 1 of 27


Assessment of Overseas General Practice Experience and Australian General Practice Experience policy (May 2010)
The Royal Australian College of General Practitioners

“Special Consideration Policy” available at: http://www.racgp.org.au/assessment/policy

“Appeals” available at: http://www.racgp.org.au/assessment/policy

“Definition of general practice and general practitioner” available at:


http://www.racgp.org.au/whatisgeneralpractice

4. BODY OF POLICY

Applicants must submit detailed and complete documentation of their general practice experience to
allow for appropriate assessment.

Intending Practice Eligible applicants who have overseas general practice experience must have their
general practice experience assessed prior to enrolling in the college assessment segments.

4.1 Assessment of general practice experience

In order to establish eligibility to participate in any of the College assessments applicants following the
Practice Eligible route will be required to undergo assessment of their general practice experience in
overseas and Australian general practice.

All candidates with overseas general practice experience must provide full details of the nature of their
overseas general practice experience and how it is similar to that in Australia, to enable the college
censors to assess its equivalence to general practice in Australia. This can be done by applying for the
following assessments of time in general practice prior to enrolling in the college assessment
segments via the Practice Eligible route.

Only general practice experience within the past 10 years, from the indemnity date shown on the
application form, can be assessed by the College Censors.

4.2 General Practice

General practice is the provision of primary continuing comprehensive whole-patient medical care to
individuals, families and their communities.

General practice involves the ability to take responsible action on any medical problem the patient
presents, whether or not it forms part of an ongoing doctor-patient relationship. In managing the
patient, the general practitioner may make appropriate referral to other doctors, health care
professionals and community services.

General practice is the first point of contact for the majority of people seeking health care, and often
therefore the first point of referral. In the provision of primary care, much undifferentiated illness is
seen; the general practitioner often deals with problem complexes rather than with established
diseases. The general practitioner must be able to make a total assessment of the person's condition
without subjecting a person to unnecessary investigations, procedures and other treatment.

4.2.1 Queensland Medical Superintendants

The experience of medical superintendents of country hospitals in Queensland has been assessed for
equivalence to general practice. Details of these assessments may be obtained from the RACGP
Queensland Faculty Censor.

4.2.2 Australian Defence Force Experience

The College may accept armed services posts for their equivalence to general practice after
consideration of whether the post meets the definition of general practice.

ID number: AS-E-022.0 Page 2 of 27


Assessment of Overseas General Practice Experience and Australian General Practice Experience policy (May 2010)
The Royal Australian College of General Practitioners

4.2.3 Academic General Practice

Part time work in academic general practice, combined with working a minimum of three sessions per
week in general practice, will be counted as equivalent to one third of the time in Australian general
practice experience.

4.3 Overseas General Practice experience

There are various categories of overseas general practice experience, training and assessment that
may lead to eligibility to participate in any of the College assessments:
• accepted postgraduate qualifications in general practice for RACGP membership (see
Specialist Pathway web pages – www.racgp.org.au/assessment/pathways)
• conjoint examination with the RACGP (Malaysia and Hong Kong).

Any other overseas clinical experience claimed as equivalent to Australian general practice is
assessed by the Board of Censors upon presentation of a detailed submission by the
applicant.

4.4 Full Time General Practice

Full time general practice is 37 hours worked per week in typical general practice activities. Full time
general practice must include work spread over at least five working days per week and must include
a minimum of nine sessions per week, none of which may be less than 3.5 hours. Working longer
hours in a week will not be calculated to accrue the doctor more than a week’s working time if the
doctor is seeking an assessment of general practice experience.

Working full time with the Australian Royal Flying Doctor Service is regarded as equivalent to full time
general practice.

4.5 Part Time General Practice

Part time experience in general practice must be for a minimum of three sessions (equivalent to a
minimum of 10.5 hours) per week in the one practice for a minimum of one month. Three sessions per
week is considered to be equivalent to 30% of full time general practice.

Experience greater than three sessions per week but less than full time will be calculated on a pro-rata
basis as determined by the number of sessions and hours worked.

The time requirement for eligibility for admission to Fellowship for doctors working part time in general
practice is limited to a maximum of 10 years in part time general practice, provided that they:
• demonstrate continuity of care
• work no less than 30% equivalent of full time general practice
• submit to the College (if requested) a log diary of 100 consecutive patient consultations to
demonstrate the depth and nature of their general practice experience, and also a curriculum
vitae containing in particular detail regarding the number of sessions worked in general
practice.

4.6 Locum Work

Full time locums in general practice are regarded as equivalent to full time general
practice provided the locum period is greater than one week duration in any one practice.

4.7 Accredited Medical Deputising Service

Work in an accredited medical deputising service for a minimum of three sessions per week may count
as general practice experience to a maximum of 2.5 years (full time equivalent). If evidence of
continuity of care can be provided, a further six months of this time may count as general practice
experience.

Employment in non-accredited after hours deputising services is not considered equivalent to general
practice.

ID number: AS-E-022.0 Page 3 of 27


Assessment of Overseas General Practice Experience and Australian General Practice Experience policy (May 2010)
The Royal Australian College of General Practitioners

4.8 Eligibility for the Practice Eligible Route

Applicants wishing to participate in any of the College assessments via the Practice Eligible route must
have:
(i) four years full time approved Australian equivalent general practice experience (or part time
equivalent) and;
(ii) at least one year full time general practice experience (of the required four years full time) to
have been gained in Australian general practice.

5. PROCEDURES

5.1 Overseas and/or Australian general practice experience assessment

Applications for assessment of overseas general practice experience or a combination of overseas


general practice experience in conjunction with Australian general practice experience are to be
submitted on the Assessment of Overseas and Australian General Practice Experience form (see
Appendix 1). Applications for assessment of Australian only general practice experience are to be
submitted on the Assessment of Australian General Practice Experience form (see Appendix 2)

Applicants are required to submit a complete application. Requests from the College for clarification
and/or additional information for an application will delay the progress of the application.

Once the complete application form is sent to the College Censors for assessment, assessment may
take up to three weeks depending on circumstances and the number of applications received.

Applicants are strongly advised to submit their application for assessment as early as possible.

Applicants must forward the complete application form with the required application fee of:

ƒ $500.00 (GST free) for non-members


ƒ $300.00 (GST free) for financial associate members

A Word version of the application form for assessment of Overseas General Practice Experience can
be obtained at www.racgp.org.au/assessment/FAQs

5.2 Right of appeal


There is an appeal process that an applicant can pursue, see:

“Appeal”, and “Board of Censor’s Decisions Review Committee” policies at


http://www.racgp.org.au/assessment/policy

5.3 Review of this policy

The review cycle for policy is three years.

ID number: AS-E-022.0 Page 4 of 27


Assessment of Overseas General Practice Experience and Australian General Practice Experience policy (May 2010)
Appendix 1

Assessment Department

NOTES TO ASSIST YOU IN THE CORRECT COMPLETION OF THE

Application Form for Assessment of


OVERSEAS & AUSTRALIAN
GENERAL PRACTICE EXPERIENCE

YOU HAVE BEEN REQUESTED TO PROVIDE


CERTIFIED COPIES OF RELEVANT DOCUMENTATION

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Refer to the “Witnessing and Certification of Documentation Policy” for those people eligible
to certify documentation
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www.racgp.org.au/assessment/policy

IF YOU ARE AN INTERNATIONAL MEDICAL GRADUATE (IMG),


REFER TO THE
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‘ENGLISH LANGUAGE PROFICIENCY POLICY’


BEFORE PROCEEDING FURTHER
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www.racgp.org.au/assessment/policy

PRIVACY POLICY
The RACGP has a Privacy Policy that reflects recent changes in Federal and State Privacy Legislation.
You may obtain a full copy of the College’s Policy from our website: www.racgp.org.au.

IF YOU ARE UNABLE TO PROVIDE ANY DOCUMENT REQUESTED


DO NOT PROCEED WITH YOUR APPLICATION
YOUR APPLICATION FORM WILL BE RETURNED TO YOU

Please post your complete application to:


Assessment Department
RACGP
1 Palmerston Crescent
South Melbourne Victoria 3205 Australia

THE CENSOR-IN-CHIEF MAY REQUEST FURTHER INFORMATION UPON REVIEW OF YOUR APPLICATION

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Assessment of Overseas and Australian General Practice Experience
Appendix 1

RACGP Assessment Department


Criteria for Assessment of Time in Overseas General Practice
The following table is a checklist which provides the criteria required to submit this application.

Please ensure that you complete the checklist before submitting your application to the RACGP. If you have
marked the NO box for any of the following questions, the RACGP will be unable to process your application.
We highly recommend that you ensure all the criteria are met for an efficient and positive outcome.

Requirement Completed
Yes No
Have all relevant sections of the form been ‘typed’ only?

Are the personal contact details complete?

Is the purpose for which an assessment is required complete?

Have three copies of the application and all supporting documentation been sent?

Is your Indemnity form witness signatory one which is listed in the RACGP’s Witnessing
and Certification Policy (www.racgp.org.au/assessment/policy)?

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Is your Statutory Declaration witness signatory one which is listed in the RACGP’s
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Witnessing and Certification Policy (www.racgp.org.au/assessment/policy)?

Has overseas clinical time in section C1 been stated?

Have all the columns within section C1 been completed?


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Is this overseas general practice experience within ten (10) years of submitting the
application?
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Has a separate section C2 been completed for each overseas medical position listed in
Section C1 and for which an assessment is being sought?

Have the hours for each workday been stated for each overseas medical position listed
in Section C1?

Were all the hours worked in each Overseas medical position listed in Section C1 as
‘general practice is defined on Page C of this application?

If no, has an outline of the duty rotations been indicated on the table provided in
Section C2?

Has a separate page been used to describe each of the A to F criteria listed within
Section C2?

Does each of the A to F criteria listed within Section C2 contain more than 5 sentences
of relevant detail?

Has a description of patients for each overseas medical position listed in Section C1
been provided?

Has a description of illnesses for each overseas medical position listed in Section C1
been provided?

Has a description of a medical record system for each overseas medical position listed
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Appendix 1
in Section C1 been provided?

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Appendix 1

Has a description of the availability of drugs and details of prescribing processes for
each overseas medical position listed in Section C1 been provided?

Has a description of all procedural work undertaken for each overseas medical position
listed in Section C1 been provided?

Has a description of the consulting rooms for each overseas medical position listed in
Section C1 been provided?

Has each of the five ‘Domains of General Practice’ listed on Page 5 of the application
been addressed?

Has the domain of Communication Skills and the Patient – Doctor Relationship been
addressed?

Has the domain of Applied Professional Knowledge and Skills been addressed?

Has the domain of Population Health and the Context of General Practice been
addressed?

Has the domain of Professional and Ethical Role been addressed?

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Has the domain of Organisational and Legal Dimensions been addressed?
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Has a separate description of the health system for each of the countries of experience
listed on Page 6 of the application been provided?

If the Primary Medical Degree is not in English, has an official and endorsed translation
to English been provided?
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Has a certified copy of a Primary Medical Degree been provided?


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Has a certified copy of current medical registration been provided?

If overseas registration was issued more than 2 years ago, has a Certificate of Good
Standing from the registering body been provided for each medical position for which
an assessment of time is being sought?

Has a certified copy of your internship certificate been provided?

Is there evidence of Postgraduate training ie General Practice/other specialities and


availability of supervision during training?

Is there verification of involvement with other general practitioners and specialists?


(please provide three letters of reference)

Is there verification of involvement with other health professionals in the practice or the
community? (please provide three letters of reference)

Has a detailed curriculum vitae (CV) been provided?

Has the tax invoice been completed?

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Assessment of Overseas and Australian General Practice Experience
Appendix 1

THE ROYAL AUSTRALIAN COLLEGE OF GENERAL PRACTITIONERS


College House, 1 Palmerston Crescent, South Melbourne Victoria 3205 Tel (03) 8699 0414
Fax (03) 8699 0400
ACN 000 223 807 ABN 34 000 223 807

RECOGNISED OVERSEAS QUALIFICATIONS FOR GENERAL PRACTICE


Please indicate 9 or 8 to each of the following questions

If you hold any of the post graduate qualifications, please contact the
Assessment Department before completing this application.
Tel: 1800 626 901 or +61-3-8699 0400 or Email: assessment@racgp.org.au
Country Qualification Yes No
9 8
Belgium Specialist Certificate in General Practice / Family Medicine
Canada Certificate in Family Medicine from College of Family Physicians of Canada
(CFPC) + Evidence of Canadian Qualifying Examinations Part 1 + 2 post
1992

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Certificate in Family Practice from the College of Family Physicians of
Canada
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Denmark Specialist Certificate in Family Medicine
Ireland Graduate of ICGP holding MICGP membership
Netherlands Certificate of Specific Training for General Practice
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New Zealand Fellow of The Royal New Zealand College of General Practitioners
(FRNZCGP)
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Norway Certificate of Specific Training for General Medical Practice


Singapore Master of Medicine in Family Medicine
South Africa Member of The College of Family Practitioners of the South African College
of General Practice
Registration as a Family Physician with the Health Professions Council of
South Africa
Master of Family Medicine
Master of Prax Medicine
Sweden Certificate of Specific Training for General Practice
United Kingdom Membership of the Royal College of General Practitioners
Certificate of the Joint Committee in Postgraduate Training for General
Practice
Certificate from the Post Medical Education Training Board
United State of Certificate of the American Board of Family Practice
America

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Appendix 1

Assessment Department

Application Form for Assessment of


OVERSEAS & AUSTRALIAN
GENERAL PRACTICE EXPERIENCE

THIS ENROLMENT FORM MUST BE


TYPED OR WRITTEN IN BLOCK LETTERS

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Office Use Only:………………………….. Date Received:……………………. RACGP Number:……………………..

Surname: ........................................................................................... Given Names:.............................................................


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Practice Address:...................................................................................................... State: ...................... Postcode: ...........

Country: ..................................................Phone No: [ ] ........................................ Fax No: [ ] ........................................


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Home Address: ......................................................................................................... State: ...................... Postcode: ...........


Country: ..................................................Phone No: [ ] ......................................... Fax No: [ ] .........................................

Email:......................................................Mobile: .......................................................... DOB:.…./.…./.…. Gender: M / F


Preferred mailing address: Practice Home Other
University Graduated From: …………………………………………………….. Year Graduated: …………………………

entry into a Rural recruitment Scheme enrolment in the next College Exam

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Assessment of Overseas and Australian General Practice Experience
Appendix 1

INDEMNITY
I acknowledge that The Royal Australian College of General Practitioners (‘RACGP’) will rely upon the
accuracy and truth of the statements and information that I provide in this application in order to assess the
time I have spent overseas in general practice. I hereby indemnify RACGP and will keep RACGP indemnified
for any loss, cost or expense incurred by RACGP as a result of any claim, action, demand or proceeding
brought by any person in respect of loss or damage arising from any false, misleading or inaccurate statement
or information provided by me in this application.

I also undertake to provide all details of any current or pending investigations, review, inquiry or sanction by a
Medical Board, Professional Services Review Director, Medicare Australia or any similar body in relation to my
professional practice or behaviour, whether in Australia or overseas.

Signature of applicant: ………………………………………………

Print Name: …………………………………………………………… Date: ………………………………..

Signature of witness*:…………………………………………………

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Print Name: …………………………………………………………… Date: ………………………………..

Title: …………………………………………………………………...
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*Refer to the “Witnessing and Certification of Documentation Policy” for those people eligible
to witness your indemnity form
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www.racgp.org.au/assessment/policy

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Assessment of Overseas and Australian General Practice Experience
Appendix 1

Statutory Declaration

I,(1) ______________________________________________________

do solemnly and sincerely declare that the information and statements contained
in my application for assessment of overseas time in general practice and in the
attachments provided with my application are accurate, true and correct
And I make this solemn declaration by virtue of the Statutory Declarations Act
1959, Commonwealth of Australia and subject to the penalties provided by that
Act for the making of false statements in statutory declarations, conscientiously
believing the statements contained in this declaration to be true in every particular.

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(2) ______________________________________________________________
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Declared at _______________________________________________
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On the ______________________ day of ________________ , 201____


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Before me,
(3) ____________________________________________________________

(4) ____________________________________________________________

(1) Here insert name, address and occupation of person making the declaration.
(2) Signature of person making the declaration.
(3) Signature of person before whom the declaration is made
(see over page for a list of persons before whom a Statutory Declaration may be
made).
(4) Here insert title of person before whom the declaration is made.

Refer to the “Witnessing and Certification of Documentation Policy” for those people eligible
to witness your Statutory Declaration form
http://www.racgp.org.au/assessment/policy

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Appendix 1

THE ROYAL AUSTRALIAN COLLEGE OF GENERAL


PRACTITIONERS
College House, 1 Palmerston Crescent, South Melbourne Victoria 3205 Tel (03) 8699 0414
Fax (03) 8699 0400
ACN 000 223 807 ABN 34 000 223 807 C1
Section 1 - Overseas Clinical Experience
NOTE: Please refer to the RACGP’s definition of the a general practitioner http://www.racgp.org.au/whatisgeneralpractice
NOTE: Only overseas general practice experience within ten (10) years prior to the application date will be considered for
this assessment.
NOTE: Full time general practice is considered 37 hours per week. Minimum acceptable part-time general practice is 10.5
hours (3 sessions) per week in the one position for a minimum of one month.

Do you consider
Dates this position
dd/mm/yy Position Name & Address & Country Full Time General Practice Office Use Only
Yes / No as defined on
From To Page B
Yes / No
±

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Assessment of Overseas and Australian General Practice Experience
Appendix 1
THE ROYAL AUSTRALIAN COLLEGE OF GENERAL
PRACTITIONERS
College House, 1 Palmerston Crescent, South Melbourne Victoria 3205 Tel (03) 8699 0414 Fax (03) 8699
0400
ACN 223 807 ABN 34 000 223 807 C2
Applications should be TYPED – if hand-written use BLOCK letters

Section 2 - Copy this page and complete BOTH part 1 & part 2
Part 1
± Position Name (from Section 1) : ________________________________________________

Start Date : _____________________ Finish Date : _____________________


dd/mm/yy dd/mm/yy

For this position only, what hours did you work each day? (eg. 8am to 5pm)
Monday Tuesday Wednesday Thursday Friday Saturday Sunday

Were ALL the hours worked in this position in general practice as it is defined in Australia?

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Yes No

If No, or if you are unsure, please outline the amount of time per week you spent in the following
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duties:

Inpatient care Work in Hospital wards


Operating theatres Emergency
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Outpatient clinics Community clinics


General Practice Other:
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Part 2 Please address ALL the following criteria for ONLY the general practice part of this position
Please ensure that each description requested below is detailed enough to enable the RACGP Censors to gain a clear
understanding of your general practice experience. Please use a separate page for each description.

A. Description of patients. Please outline the types of patients seen. For example: how many male/female patients,
what was the age distribution.

B. Description of illnesses seen. Please outline the types of illnesses seen. How were these patients followed up and
by whom?

C. Description of medical record system used. Please outline the medical record system used.

D. Description of availability of drugs. Please outline the availability of drugs and details of prescribing processes.

E. Description of procedural work undertaken. Please outline the details of all procedural work done.

F. Description of consulting rooms. Please describe the consulting rooms.

G. Domains of General Practice On the following page is a list of the “Domains of General Practice”.
These domains define the role of Australian General Practitioners within the Australian Primary Healthcare
system. Please give a description of how your General Practice experience correlates across these domains.

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Domains of Australian General Practice

Communication Skills and the Patient – Doctor Relationship


1.1 The General Practitioner as a therapeutic agent
1.2 Patient-Centeredness
1.3 Establishing Rapport
1.4 Communication with patients' significant others
1.5 Consultation Models
1.6 Counselling Skills
1.7 Advocacy Role for the individual patient
1.8 Interaction of Family Dynamics with health and illness
1.9 Communication with patients from difft cultural backgrounds
1.10 Communication with special needs groups
1.11 Individual & opportunistic health education promotion
1.12 Care coordination, referrals and networking

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1.13 Written communication skills
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Applied Professional Knowledge and Skills Population Health and the Context of General
Practice
2.1 Knowledge of Medical Conditions – common
2.2 Knowledge of Medical Conditions – treatable 3.1 Demographic & epidemiological issues - health needs of
2.3 Knowledge of Medical Conditions – preventable special groups
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2.4 Knowledge of Medical Conditions - dysfunctional, 3.2 Knowledge of public health problems
disabling or life-threatening 3.3 Population-based preventive strategies
2.5 Knowledge of Medical Conditions - uncommon, but 3.4 Cultural aspects of health care
serious 3.5 Socio-political dimensions of health
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2.6 Knowledge of Medical Conditions - masquerading 3.6 Advocacy role in the community--.
illnesses 3.7 Patient context - family, work and significant others
2.7 Approach to undifferentiated problems 3.8 Community resources
2.8 Information gathering
2.9 Physical examination skills
2.10 Procedural skills
2.11 Clinical decision making
2.12 Continuity of Care
2.13 Integration of care
2.14 Cost-effective treatment and investigations
2.15 Critical appraisal

Professional and Ethical Role Organisational and Legal Dimensions


4.1 Special duty of care 5.1 Arrangements for availability and accessibility
4.2 Maintenance of professional standards 5.2 Safety-netting
4.3 Adherence to contemporary ethical principles 5.3 Screening and recall systems
4.4 Reflective skills and self-appraisal 5.4 Information management – patient and practice
4.5 Lifelong learning and continuous professional 5.5 Information technology
development 5.6 Medical records
4.6 Teaching role 5.7 Legal responsibilities
4.7 Research, evaluation & audit skills 5.8 Practice management
4.8 Professional networks
4.9 Self and family care

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Appendix 1

A
THE ROYAL AUSTRALIAN COLLEGE OF GENERAL RACTITIONERS
College House, 1 Palmerston Crescent, South Melbourne Victoria 3205 Tel (03) 8699 0414 Fax (03) 8699 0400
ACN 223 807 ABN 34 000 223 807

Australian Clinical Experience


SECTION 1 HOSPITAL EXPERIENCE – Including registration year – Australia only

Dates Hospital Discipline Duration Office


From To Years and Months Use Only

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TOTAL

SECTION 2 GENERAL PRACTICE EXPERIENCE - Australia only


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Dates Full Part Time Duration Office


From To sessions
Practice Names and Address Time Years & Use Only
per Week
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Months

TOTAL

PRIVACY POLICY: The RACGP has a Privacy policy that reflects Federal and State privacy legislation.
A full copy of the College’s policy is available from our website: www.racgp.org.au

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Appendix 1

Assessment Department

TAX INVOICE
The Royal Australian College of General Practitioners
1 Palmerston Crescent South Melbourne VIC 3205 Australia
ACN 000 223 807 ABN 34 000 223 807

PAYMENT DETAILS
for
APPLICATION FOR ASSESSMENT OF
OVERSEAS & AUSTRALIAN
GENERAL PRACTICE EXPERIENCE
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MEMBER $300.00
FEES PAYABLE
Including GST
NON-MEMBER $500.00
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FIRST NAME
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SURNAME RACGP NO.


(if applicable)

WHAT IS YOUR PREFERRED DAYTIME CONTACT NUMBER

DATE RACGP MEMBER … YES … NO

… CHEQUE (make payable to the RACGP) … Amex … Visa … MasterCard

CARD NUMBER ………… ………… ………… …………


CARDHOLDER
NAME (please print clearly) EXPIRY DATE …… / ……
CARDHOLDER SIGNATURE TOTAL AMOUNT $AUD

DO YOU REQUIRE A RECEIPT? Yes No


Please print clearly and keep a copy of this form for your records. For more information telephone 1800 626 901 or email
assessment@racgp.org.au. All fees quoted are inclusive of GST. This form will become your tax invoice upon payment.
ABN 34 000 223 807.
OFFICE USE ONLY
Batch No. Order No. Invoice No.
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Appendix 1

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Assessment of Overseas and Australian General Practice Experience
Appendix 2

Assessment Department

NOTES TO ASSIST YOU IN THE CORRECT COMPLETION OF THE


APPLICATION FORM
for
ASSESSMENT OF TIME IN
AUSTRALIAN GENERAL PRACTICE

IF YOU ARE NOT A CURRENT MEMBER OF THE RACGP


WE ARE UNABLE TO PROCESS YOUR APPLICATION
For information on how to become an RACGP member visit our website: www.racgp.org.au/membership

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YOU HAVE BEEN REQUESTED TO PROVIDE
CERTIFIED COPIES OF RELEVANT DOCUMENTATION

THE COLLEGE WILL ONLY ACCEPT CERTIFICATION FROM A


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REGISTERED JUSTICE OF THE PEACE (JP)


(with evidence of their Registration Number)
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TO OBTAIN NAMES OF JPs IN YOUR LOCALITY PLEASE CALL 1300 365 567

IF YOU ARE AN INTERNATIONAL MEDICAL GRADUATE (IMG),


PLEASE READ THIS SECTION BEFORE PROCEEEDING FURTHER

ENGLISH LANGUAGE REQUIREMENTS

Please refer to the RACGP English Language Proficiency Policy


www.racgp.org.au/assessment/policy

Application for Assessment of Time in Australian General Practice March 2010 Page 19 of 27
Appendix 2

ALL APPLICANTS WILL NEED TO PROVIDE THE FOLLOWING DOCUMENTATION


CONFIRM THAT YOU CAN PROVIDE WHAT HAS BEEN REQUESTED BYMARKING EACH
BOX WITH A TICK (√ )

Written confirmation (on practice letterhead) signed by the Principals from the practice(s) or relevant
hospital(s) or clinic(s) indicating:
ƒ the specific dates you were/are employed
ƒ the exact nature of the work are/were required to cover (description of duties)
ƒ whether you worked full-time or part-time
ƒ duration of sessions

A certified copy of your current medical registration (an expiry date must be shown).

A certified copy of your primary medical degree.

A letter of approval from the RACGP Censor-in-Chief indicating previous assessments of time
(if applicable).

A copy of your current curriculum vitae.

E
PL
THE CENSOR-IN-CHIEF MAY REQUEST FURTHER INFORMATION UPON REVIEW OF YOUR APPLICATION
M
SA

IF YOU ARE UNABLE TO PROVIDE ANY DOCUMENT REQUESTED


DO NOT PROCEED WITH YOUR APPLICATION
YOUR APPLICATION FORM WILL BE RETURNED TO YOU

Application for Assessment of Time in Australian General Practice March 2010 Page 20 of 27
Appendix 2

Assessment Department

APPLICATION FORM
for
ASSESSMENT OF
AUSTRALIAN GENERAL PRACTICE EXPERIENCE
T H I S A P P L I C AT I O N F O R M M U S T B E
TYPED OR WRITTEN IN BLOCK LETTERS

FOR WHAT PURPOSE DO YOU REQUIRE AN ASSESSMENT OF YOUR


AUSTRALIAN GENERAL PRACTICE EXPERIENCE?

E
(tick relevant box)
PL
ENROLMENT IN THE NEXT ENTRY INTO THE
COLLEGE
RACGP SPECIALIST
MEMBERSHIP College Practice Based Modular Assessment PATHWAY PROGRAM
M

Examination Assessment Pathway


SA

PERSONAL DETAILS
FIRST
NAME(S)
MIDDLE
NAME(S)

SURNAME

DATE OF RACGP NO.


BIRTH if applicable

CONTACT DETAILS
PRACTICE ADDRESS
Street / Road
Number
Street / Road
Name
Town

City Post Code


Application for Assessment of Time in Australian General Practice March 2010 Page 21 of 27
Appendix 2
Country

HOME ADDRESS
Street / Road
Number
Street / Road
Name
Town

City Post Code

Country

OTHER ADDRESS
Street / Road
Number
Street / Road
Name
Town

E
PL
City Post Code

Country
M

My preferred mailing address is: Practice Home Other


tick relevant box
SA

TELEPHONE / FAX NUMBER AND EMAIL ADDRESS


Home (include area code)
Practice (include area code)
Fax (include area code)
Mobile
Email (mandatory)

ACADEMIC BACKGROUND
Office Use Only
PRIMARY Date
QUALIFICATION Awarded
(attach additional page if Qualification
required)
University

College
Application for Assessment of Time in Australian General Practice March 2010 Page 22 of 27
Appendix 2
Country

Office Use Only


Date
Awarded
OTHER MEDICAL
Qualification
QUALIFICATIONS
(attach additional page if University
required)
College
Country

Office Use Only


Date
Awarded
OTHER MEDICAL
Qualification
QUALIFICATIONS
(attach additional page if University

E
required)
College
PL
Country

Office Use Only


Date
Awarded
M

NON MEDICAL
Qualification
QUALIFICATIONS
SA

(attach additional page if University


required)
College
Country

Office Use Only


Date
Awarded
NON MEDICAL
Qualification
QUALIFICATIONS
(attach additional page if University
required)
College
Country

Office Use Only


MEDICAL Registration
REGISTRATION Number
Status

Start Date

Application for Assessment of Time in Australian General Practice March 2010 Page 23 of 27
Appendix 2

Expiry Date
Registration
Body

HOSPITAL EXPERIENCE inc REGISTRATION YEAR


(attach additional page if required)

Office use Only

Date From To
Hospital

Discipline

Duration Years

E
Months
PL
Office use Only

Date From To
Hospital
M

Discipline
SA

Duration Years Months

Office use Only

Date From To
Hospital

Discipline

Duration Years Months

Office use Only

Date From To
Hospital

Application for Assessment of Time in Australian General Practice March 2010 Page 24 of 27
Appendix 2

Discipline

Duration Years Months

E
PL
M
SA

Application for Assessment of Time in Australian General Practice March 2010 Page 25 of 27
Appendix 2

Office use Only

Date From To
Hospital

Discipline

Duration Years Months

Office use Only

Date From To
Hospital

Discipline

E
PL
Duration Years Months
M

GENERAL PRACTICE EXPERIENCE (AUSTRALIA ONLY)


(attach additional page if required)
SA

Note
minimum acceptable part-time experience is 10.5 hours (three sessions per week) in the one practice for a minimum of one month

Office Use Only


Date From To
Practice Name
Location
Part Time Years
Full Time Hours
Sessions
Per Week
Per week Months

Office Use Only


Date From To
Practice Name
Location
Full Time Hours Part Time
Years
Per Week Sessions

Application for Assessment of Time in Australian General Practice March 2010 Page 26 of 27
Appendix 2
Per week
Months

Office Use Only


Date From To
Practice Name
Location
Part Time Years
Full Time Hours
Sessions
Per Week
Per week Months

Office Use Only


Date From To
Practice Name
Location
Part Time Years
Full Time Hours
Sessions
Per Week Months

E
Per week
PL
INDEMNITY
I acknowledge that The Royal Australian College of General Practitioners (RACGP) will rely upon the accuracy and
truth of the statements and information that I provide in this application in order to assess the time I have spent in
Australian general practice. I hereby indemnify RACGP and will keep RACGP indemnified for any loss, cost or
expense incurred by RACGP as a result of any claim, action, demand or proceeding brought by any person in
M

respect of loss or damage arising from any false, misleading or inaccurate statement or information provided by me
in this application.
SA

I also undertake to provide all details of any current or pending investigations, review, inquiry or sanction by a
Medical Board, Professional Services Review Director, Medicare Australia or any similar body in relation to my
professional practice or behaviour in Australia.

Name
Signature Date

APPLICATION FORM AND CERTIFIED DOCUMENTS MUST NOT BE


EMAILED OR FAXED
MAIL TO
Assessment Department
RACGP
1 Palmerston Crescent
SOUTH MELBOURNE VIC 3205 AUSTRALIA

For queries, contact:


Assessment Department on Free Call 1800 626 901

PRIVACY POLICY
Application
The for Assessment
RACGP has aofPrivacy
Time inPolicy
Australian
thatGeneral
reflectsPractice
recent changesMarch 2010 and State Privacy Page
in Federal 27 of 27
Legislation.
You may obtain a full copy of the College’s Policy from our website: www.racgp.org.au.

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