Hospital training requirement
Mandatory hospital rotations and requirements for GP registrars
Paediatric experience and certain hospital rotations, including medicine, emergency medicine and surgery, prepare you to train and practise as a GP registrar.
You need to complete the prerequisite training before you can start your GP placements. The requirements are different depending on which fellowship you’re completing.
Some people deride the hospital system but the learning opportunities there are fantastic. It’s the last time in registrars’ lives that they’ll get really concentrated diseased states or groups of populations of people to look after. It’s a concentrated learning environment with really good supervision.Dr John Buckley, GP and Director of Medical Education at GPTQ
Meeting the GP college requirements
We train you towards achieving a GP fellowship at either or both of Australia’s GP colleges: RACGP and ACRRM. This is the qualification required to practise independently as a GP in Australia. Both colleges require you to complete mandatory hospital rotations to meet your training and fellowship requirements.
You need to:
- Complete a minimum of 12 months post-intern hospital training in an accredited Australian hospital.
- Complete mandatory rotations and the paediatric requirement to meet the fellowship requirements of RACGP and/or ACRRM. The mandatory requirements can usually be met during any part of your Australian hospital experience. These rotations should be completed before you start your GP placements.
Mandatory hospital rotations and requirements for both GP colleges
To achieve Fellowship, both RACGP and ACRRM require doctors to complete:
- General medicine rotation
- General surgery rotation
- Emergency medicine rotation
- Paediatrics requirement
The paediatric requirement can be met via a a paediatric rotation or in different ways set out by the individual colleges. See below.
Note: Both Colleges have recency of practice requirements which must be adhered to.
In addition to completing the mandatory rotation/experience, if your last exposure to any of these broad disciplines was more than four years ago, it is likely that additional evidence may be required by the Colleges to demonstrate maintenance of competency.
This evidence will be required by GPTQ to confirm your eligibility to commence a GP placement. For further information, please refer to the GPTQ program information document on hospital training and eligibility to start GP terms.
RACGP’s mandatory hospital rotations
In addition to completing mandatory rotations in medicine, surgery and emergency medicine, RACGP requires you to complete a minimum of three rotations of your choice relevant to general practice. You also need to meet the paediatric requirement, as outlined below. If the paediatric requirement is met by a paediatric term, this can be one of your three required additional rotations. If it is met or partly met by emergency rotations, these rotations can contribute to both the emergency and the paediatric requirements.
Your three elective rotations may be in:
- Accident and emergency (ie. a second rotation in this discipline)
- General medicine (ie. a second rotation in this discipline)
- Infectious diseases
- Obstetrics and gynaecology
- Prevocational general practice (PGPPP)
Other relevant hospital experience may be acceptable, at the discretion of GPTQ and RACGP.
Visit RACGP’s general practice guide for students and junior doctors for more information.
ACRRM’s mandatory hospital rotations
In addition to medicine, emergency medicine and surgery, ACRRM requires you to complete rotations in:
- Obstetrics and gynaecology
ACRRM also recommends the following disciplines:
- Aged care
- Palliative care
- Emergency medicine
You also need to meet the paediatric requirement, as outlined below. Visit ACRRM’s core clinical training policy for more details about mandatory hospital rotations.
In general, a 10-week paediatrics term done between the intern and hospital / core clinical training year can count towards meeting the paediatric requirement. Each college has its own recency requirements and for older terms you may be required to demonstrate how you have maintained currency of skill.
Meeting your paediatric requirement for RACGP
Paediatric rotations are competitive, and it can be challenging to secure a place. You may need to accumulate paediatric experience through other relevant experience.
Here are some of the ways you can meet your paediatric requirement for RACGP:
- A full term in paediatrics or paediatrics ED.
- A half term of 5-6 weeks in paediatrics combined with a full term in emergency where children represent at least 20 per cent of the presentations and you are the first doctor assessing them.
- Two full terms in emergency, as long as only one is in your intern year and the other (or both) is in your second postgraduate year or later.
- Completion of a relevant course that’s been approved by RACGP, such as the Sydney Child Health Program from the Children’s Hospital at Westmead, in combination with some experience as above.
Meeting your paediatric requirement for ACRRM
For ACRRM, registrars who have not undertaken a 10-week paediatrics term must complete:
- two educational activities in child health (an online module or workshop provided by an RTO or other provider).
- and one of the following:
- An integrated rural hospital term (e.g. PIERCE term), which includes paediatrics, under supervision (on or offsite) of a specialist paediatrician or a GP with advanced skills in paediatrics.
- Work in an Emergency Department for a minimum of six months where paediatric cases represent at least 25 per cent of the presentations.
- A 25-week term assisting a paediatrician (or paediatric team) providing outreach paediatric services.
- Community primary care post of no less than six months
- The Sydney Child Health Program (SCHP) from the Children’s Hospital at Westmead
- Undertake Advanced Specialised Training in Paediatrics
- Combinations of above, approved by ACRRM.
Registrars undertaking the six-month terms (or options 1-4 above) are required to provide a supervisor report and a log of (minimum 50) paediatric cases seen. Registrars undertaking the SCHP or AST are only required to provide a certificate of successful completion. For additional information, please look up the Core Clinical Training section of ACRRM’s Fellowship Training Handbook.
Frequently asked questions
Can I start general practice terms without completing all of my mandatory hospital rotations?
As a general rule, you cannot. Any mandatory hospital rotation will need to be completed before you can start general practice terms. However, there may be circumstances where this is not possible. Discuss your options with your medical educator at the RTO.
What qualifies as a full hospital year?
A full hospital year is defined as 52 weeks of full-time work with a maximum of five weeks leave within that time.
Can I do my hospital year outside the training region of my RTO?
Yes, but only if you already hold an existing contract for that training hospital before you start your AGPT training. You can then complete the hospital year of your training outside your RTO’s region, as long as the placement is approved and counts towards your mandatory hospital rotation requirements. You will also need to advise the RTO of this intention at the time of accepting the offer to train with them.
Can a Diploma in Obstetrics and Gynaecology count towards my mandatory hospital rotations?
The Diploma itself will not count towards your mandatory rotations, but hospital time undertaken may count towards one of your mandatory hospital rotations or perhaps extended skills. You should discuss this with a General Practice Training Queensland administrator or Medical Educator.
Is Obstetrics and Gynaecology a requirement for GP Training?
It depends on the college for which you are seeking fellowship. Obstetrics and gynaecology is not a requirement for RACGP. However, it is for ACRRM.
Can a sub-specialty term in medicine (e.g. geriatrics or cardiology) count towards my medicine term requirement?
Yes, it may count.
Will a sub-specialty term in surgery (e.g. neurosurgery or urology) instead of general surgery count towards the surgical term requirement?
Yes, it may count.
Can the terms I have completed in my intern year be counted towards the mandatory hospital rotations?
Yes. In fact, in many cases, most of the core rotations are completed during internship.
Can I apply for the Australian General Practice Training (AGPT) program without having completed all of my mandatory hospital rotations?
Yes you can. You would then complete the hospital year of the Australian General Practice Training (AGPT) program wherein you would complete these requirements.
If I want to do more hospital work during the AGPT program, either as my first training year or later during my training, how do I arrange my hospital job?
You will need to arrange your own hospital work. Your regional training organisation (RTO) can give advice but cannot organise placements. You will need to either apply through the respective state health medical recruitment campaigns or directly to the accredited, approved hospitals in your training region. You should check with your regional training organisation (RTO) that the hospital and disciplines in which you wish to work are suitable to be able to count towards your AGPT training requirements.
What are the mandatory hospital rotations for the AGPT program?
Both the ACRRM and RACGP require you to complete a paediatric requirement and the three mandatory hospital rotations: general medicine, general surgery and emergency medicine.
Both colleges have further – but different – mandatory requirements for additional hospital rotations. This training must be completed before starting your GP placements. For details please refer to the mandatory hospital rotations on this page above.
Can I start GP placements without meeting the paediatric requirement?
Generally speaking, this is not possible if you are training towards a FRACGP. On the other hand, it may be possible if you are pursuing a FACRRM, if you can demonstrate safe practice in the paediatric discipline. At GPTQ, you will need approval from your GPTQ medical educator. Please contact GPTQ to discuss.
I have not been able to get a 10-week paediatric rotation. How can I meet the paediatric requirement for GP training?
There are alternative ways to meet your paediatric requirement as detailed on the page above. If you are a current GP registrar, please discuss with your GPTQ medical educator.
What is the paediatric requirement for GP training?
You need to meet the paediatric requirement before starting your GP placements. The requirement differs for each college, so will depend on which fellowship you’re completing. For further information, please view the page above.
Is there any other way I can meet the paediatric requirement? Can general practice experience count?
There are other ways to meet the paediatric requirement besides completing a paediatric rotation. However, general practice experience does not count towards the requirement. To find out more please refer to the ACRRM fellowship handbook or the RACGP paediatric term requirements guidance document.
Why is there a mandatory paediatric requirement for GP registrars?
As a practising GP, you’re likely to treat babies, kids and teenagers. Children can go from being well to sick and seriously ill in a couple of hours. The paediatric requirement ensures you develop competence in the detection and management of serious or potentially serious illness in children – from birth to middle childhood and beyond. It is important you gain this vital clinical experience before you start your first GP training placement.
What are the best rotations to do during my hospital year for meeting the paediatric requirement?
The best hospital rotations to prepare you for GP training are in the paediatric ward, paediatric emergency or general emergency with a good presentation of paediatric cases (>20%) and where the RMO is the first to see them. This gives you experience in diagnosing and treating seriously ill children. A sub-specialty paediatric term (neurology or neonatal intensive care for example), whilst valuable in itself, does not give the same opportunity for initial diagnosis. However, these sub-specialty terms will still meet the requirement if completed in conjunction with sufficient paediatric emergency or mixed emergency time.
I have completed 10 weeks of emergency medicine where I saw children first (at least 20 per cent of the case load) and five weeks of a paediatric rotation. Have I met my mandatory paediatric requirement?
This combination of experience meets the paediatric rotation requirements for fellowship of The RACGP. For further information, you can also refer to the RACGP paediatric term requirements guidance document. ACRRM, on the other hand, has different requirements. You can find out more about these on the page above or in the ACRRM fellowship training handbook (page 10).
When do I need to complete the paediatric requirement?
To meet the requirements of The Royal Australian College of General Practitioners (RACGP) you will typically need to complete your paediatric requirement before starting your first general practice term. To meet the requirements of the Australian College of Rural and Remote Medicine (ACRRM) you will typically need to complete your prerequisite training before starting your first primary rural and remote training placement.
For more information on meeting the paediatric requirements please refer to the ACRRM fellowship training handbook or RACGP paediatric term requirements guidance document.