Placements for 2019 have opened and it’s time to consider your next rotation. RLO, Dr Krystyna de Lange provides advice on choosing a placement that is right for you.
- Consider how the location will impact the work
Location will impact on the type of work you do and the patients you see. Check whether the practice is situated in a low or high socio-economic area. Is it in an area where you are likely to see a skewed population? For example, will your patients be refugees or corporate types or young families or geriatrics. Are there plenty of services nearby or co-located? Think about you and your family too. Is the practice a reasonable drive from home or other places you need to be such as childcare, school, family, out of work activities? It is important not to over commit to a long commute.
- Think about going rural
Many registrars who choose rural for their GP training have very positive experiences. Rural practice can offer a level of diversity, complexity and unique challenges not available in metropolitan areas. A rural practice can give you the opportunity to do a mix of community and hospital-based work, after hours and on call, procedural work and non-clinical roles. Think about whether this is your chance to try something different and go rural. You may love it and never want to come back.
- Look for a variety of practice
RACGP registrars have a two-practice minimum rule for a good reason. Exposure to a variety of general practice experiences will improve your training experience. Think about trying out smaller and larger practices; bulk billing and mixed billing; metropolitan and outer metropolitan / rural practices. Do you have a special interest area that you want to develop? Consider looking for practices where there are GPs with extra qualifications in this special interest area.
- Check the working hours
Be sure the practice you are applying to is able to accommodate the number of hours you want to work. Take note of the practice opening hours as they are likely to reflect what you will be expected to work – for example, after hours and weekends. Ask the practice about the expectations for registrars working after hours and what the supervision will look like during these times. Don’t commit to a clinic where there is an expectation of lots of after-hours work if that is not something you can manage.
- Make sure you can manage the patient load
Registrars are expected to see between two to four patients per hour. Ask the practice the patient load expectation for your level of training. Are they happy to be flexible? Are they happy for you to schedule in some catch up sessions and/or administration time? Find out the process for walk-ins or dispersing patients when colleagues are sick.
- Take note of the support staff
Practice support staff can really make or break a practice. Find out if receptionists and nurses work on weekends and after hours, and the ratio of nurses to GPs. Will the nurses help with vaccinations, health checks, care plans, other medicals, ECGs and so on? Make a point of saying hello to the receptionists and nurses at your interview – do you get a warm response? Remember, they are often the first point of contact for your patients.
- Ask about the resources and equipment
Resources and equipment provided will vary between practices. Check not only what is provided but also what condition it is in. The last thing you want, is to turn up on your first day, and realise you need to purchase a lot of equipment yourself or maintain private subscriptions to resources such as eTG and UpToDate. Remember that GPTQ can help with the loan of equipment such as diagnostic kits and dermatoscopes.
- Check out the processes
Does the practice have streamlined and reliable processes in place? Are there regular meetings that cover both clinical and non-clinical topics? Think about reminders and recalls and results checking when others are away. Is there remote access to the practice software? How do patient bookings work and are there reminder systems in place for appointments? Is there a policy for cancellations and failure to attend? Does the practice have a website and/or social media? If so, check it out. Is it appealing to the public? Is there appropriate marketing? Do the values of the clinic align with you?
- Find out about the supervision and education
Perhaps the most important aspect of choosing a practice is the supervision. A supervisor who you trust, is approachable and is ultimately invested in teaching and education will have a huge impact on your training experience. Find out how often your supervisor will be on site and the back-up plan when there is no on-site supervision. Ask about what in practice teaching looks like for current and previous registrars, including how much, how often, who with, what topics and teaching styles.