Royal Australian College of General Practitioners
 | |
| Abbreviation | RACGP |
|---|---|
| Formation | 1958 |
| Legal status | professional body |
| Purpose | Regulation and representations of GPs |
| Headquarters | East Melbourne, Victoria |
| Location |
|
Region served | Australia |
President | Dr Frank Jones[1] |
| Website | http://www.racgp.org.au/ |
The Royal Australian College of General Practitioners (RACGP) is the professional body for general practitioners (GPs) in Australia. The RACGP is responsible for maintaining standards for quality clinical practice, education and training, and research in Australian general practice. The RACGP has the largest membership of any medical college in Australia, representing both urban and rural GPs.[2]
The RACGP vision is for a 'Healthy Profession, Healthy Australia'. The organisational mission is to improve the health and wellbeing of all people in Australia by supporting GPs, general practice registrars and medical students through its principle activities of education, training and research, and by assessing doctors' skills and knowledge, offering ongoing professional development activities, developing resources and guidelines, advocating for GPs on issues that affect their practice, and developing standards that general practices use to ensure high quality healthcare.[3]
Organisation
The President and Council
The RACGP is governed by the RACGP Council. The RACGP Council comprises:
- President
- Vice President
- Chair of Council
- Censor-in-Chief
- The Chair of each state/territory faculty
- Chair of the National Rural Faculty
- Chair of the National Faculty of Aboriginal and Torres Strait Islander Health
- Chair of the Finance Audit and Risk Management Committee
- General Practice Registrar Representative
- Any additional Council members co-opted by RACGP Council permitted under the RACGP Constitution.
Faculties
There are eight faculties within the RACGP, representing different geographical regions and special interest groups.
This includes five state-based faculties, serving the needs of members practising in their respective geographical regions; Western Australia, Victoria, Queensland, South Australia & Northern Territory, and New South Wales & Australian Capital Territory.
The National Rural Faculty (NRF) of the RACGP supports and advocates for GPs working in rural and remote communities across Australia.
The National Faculty of Aboriginal and Torres Strait Islander Health was formed as part of the RACGP’s commitment to raising awareness of Aboriginal and Torres Strait Islander health needs, and therefore to help 'close the gap'.
The National Faculty of Specific Interests (NFSI) was established in 2008 to recognise the additional interest and expertise held by GPs in selected areas of general practice. The NFSI facilitates GP members practising in these areas to promote the area of specific interest and to share and develop related knowledge and materials.
Membership
The RACGP has 31,500 members across Australia and internationally.
Categories of membership
The categories of membership are:
- Fellow - RACGP Fellows who have successfully completed all RACGP Fellowship assessment requirements, have satisfied RACGP Council of their competence through training and/or experience, and who hold current Australian medical registration.
- Member - medical practitioners who have five years specialist registration with AHPRA, five years consecutive participation in the QI&CPD program and two referees, both of whom must be a financial Fellow or Member of the RACGP.
- Associate - registered medical practitioners who are not Fellows or ‘full’ Members are categorised as associate members under the RACGP constitution.
- Registrar Associate - general practice registrars who are participating in general practice vocational training are eligible to become Registrar Associate members.
- Student - medical students who are currently enrolled in an undergraduate or graduate course approved by an Australian medical school, including a Bachelor of Medicine or a Bachelor of Biomedical Science, can join the RACGP as student members.
Fellowship and examinations
Fellowship of the RACGP
The RACGP Fellowship is the admission to the specialty of general practice. It is an important recognition from the RACGP and the profession of general practice, and represents excellence in general practice.
In 1996, the Australian Government adopted Fellowship of the RACGP (FRACGP) as the standard for certifying competence to deliver unsupervised general practice services in any general practice setting in Australia – urban, regional, rural or remote.
Fellowship of the RACGP allows GPs to:
- Work unsupervised in general practice
- Claim A1 Medicare rebates
- Use the post nominal ‘FRACGP’
- Be recognised as a Fellow through a reciprocal arrangement with New Zealand, Ireland and Canada.
FRACGP exams
The RACGP Fellowship exam consists of three segments; applied knowledge test (AKT), key feature problems (KFP) and objective structured clinical exam (OSCE). The exams are delivered in various locations across Australia and delivery of the conjoint Fellowship is delivered in Hong Kong and Malaysia. Passing of each component of the RACGP Fellowship exam is the usual way GPs become eligible to apply for their FRACGP.
Practice based assessment
Practice based assessment (PBA) is an alternative fellowship assessment for GPs who wish to achieve their FRACGP. The examination is only open to candidates who qualify via the practice eligible pathway and are actively working in general practice.
Membership of the RACGP is mandatory for any medical practitioners hoping to obtain fellowship of the RACGP via any of the training pathways.
Quality improvement and continuing professional development
QI&CPD program
The RACGP quality improvement and continuing professional development (QI&CPD) program supports Australian GPs to provide the best possible care for patients. It does this by recognising ongoing education and promoting the development and maintenance of general practice skills and lifelong learning.
Medicare Australia requires all GPs who access any Medicare program or service to participate and complete all requirements of a recognised CPD program.
In the absence of fellowship of any of the specialty colleges, a GP will typically take up participation of the QI&CPD program in order to satisfy medical registration requirements with the Australian Health Practitioner Regulation Agency (AHPRA), the national medical registration body. Participation in the QI&CPD program should not be confused with fellowship of the RACGP.
Advocacy
The RACGP advocates for GPs and general practice, promoting the importance of patient safety, quality care, coordination of care, whole patient care, better recognition and reward for GPs, and investment into primary healthcare infrastructure, teams, training, and technology. The breadth of the RACGP's work is reflected by its various advocacy efforts.
Publications and events
Publications
The RACGP publishes Australian Family Physician (AFP), Australia's main peer-reviewed academic medical journal for GPs. AFP aims to provide relevant, evidence-based, clearly articulated information to Australian GPs to assist them in providing the highest quality patient care; applicable to the varied geographic and social contexts in which GPs work. All articles are subject to a peer review process before they are accepted for publication. The journal is indexed in MEDLINE, Index Medicus and Science Citation Index Expanded.
Good Practice is a monthly news magazine published by the RACGP. Good Practice highlights the issues that affect general practice in Australia through in-depth stories and news and views. Regular series include business, technology, e-health, reviews and updates, and lifestyle.
In Practice is a bi-weekly email newsletter sent from the president of the RACGP to all members and key stakeholders, every Tuesday and Friday.
Events
Each year the RACGP holds an annual conference in a different location around Australia. The 2015 conference GP15 was held in Melbourne from 21–23 September 2015 under the theme 'Our future in practice' and was attended by more than 1400 delegates. The RACGP annual conference is an opportunity for GPs and other healthcare professionals to discuss various educational themes, attend clinical workshops and research presentations, and network with one another to support their professional development.
The various faculties and departments of the RACGP host many educational and collegial events throughout the year, including fellowship ceremonies, awards nights, workshops and seminars.
History of general practice in Australia and beyond
Prior to the mid 20th century, upon graduation Australian doctors spent time in general practice. A medical career usually included completing an intern year immediately after graduation as a resident in a major teaching hospital. After a period of time in general practice, some doctors would seek specialist qualifications. Possibly reflecting the historical origins of Australia as a series of British colonies, these doctors would travel overseas, most often to the UK, to specialise and then return to establish practice.[4]
As the Australian population grew post World War II, the public hospital system also grew demanding an increasing number of specialists. Local training program emerged and therefore the ability of a doctor to enter specialist training directly following the mandatory intern year post graduation without entering general practice. This increasing number of specialists made it increasingly difficult for general practitioners in Australia to hold and retain public hospital appointments, especially in procedural areas such as surgery or obstetrics.
This was not a uniquely Australian phenomenon. Worldwide, medical practice was shifting focus onto hospitals with the expansion of pharmaceuticals and medical and surgical interventions. In the United States, the number of doctors identifying as general practitioners fell markedly between 1931 and 1974 from 83% to 18%. This process began as specialisation increased prior to the War. US GPs increasingly felt that health care was becoming fragmented and weakening doctor patient relationships.[5]
“There are 57 different varieties of specialist to diagnose and treat 57 different varieties of disease but no physician to take care of the patient."[5]
Development of professional colleges
In 1950, an Australian Graduate, Dr Joseph Collings, conducted a review of general practice in the UK. This 30-page report was published in the Lancet in 1950.[6]
“There are no real standards for general practice. What a doctor does and how he does it depends entirely on his own conscience” Dr Collings, 1950.[6]
Dr Collings’ report was scathing and generated immediate and heated interest. It was undoubtably a key event in the definition of general practice as a "speciality."[7]
He identified that general practice has no academic underpinning, no evidence upon which to base practice and no consistency of practice. The report did not pull punches. He described rural practice is “an anachronism”, suburban practice is a “casualty-clearing” service and Inner city practice is “at best… very unsatisfactory and at worst a positive source of public danger.”[6][7]
There is a direct link between the public criticism of general practice and the move to create a College. Dr Rose and Dr Hunt in the BMJ 1950 write:
“There is a College of Physicians, a College of Surgeons, a College of Obstetricians and Gynaecologists, a College of Nursing, a College of Midwives and a college of Veterinary Surgeons, all of them Royal Colleges; there is a College of Speech Therapists and a College of Physical Education, but there is no college or academic body to represent primarily the interests of the largest group of medical personnel in this country – the 20,000 general practitioners.” [8]
Interestingly, there was opposition in the UK to the creation of a College by the existing three Medical Colleges – Colleges of Surgeons, Physicians and Obstetricians and Gynaecologists – who held the belief that general practice should be a joint faculty of general practice linked to the existing Colleges.[9] However, put into perspective, in the same document Hunt describes the two original British Colleges sought to stop the creation of the College of Obstetricians and Gynaecologists via legal action in 1929.
The development of the Australian College of General Practitioners
The British College of General Practitioners was formed in 1953 with many Australian doctors amongst the founding members including the RACGP’s first president Dr William Conolly, again reflecting the origins of Australia as a series of British colonies, established a New South Wales faculty of the BCGP. This was followed by the creation of other state based faculties of the British College of General Practitioners in Queensland, Western Australia, Tasmania, Victoria and South Australia over the next 5 years.
In keeping with the process for creating Medical Colleges under the British system, a group of Australian General Practitioners met in 1957 at the first Annual Scientific Convention in Sydney to declare an intention to form the Australian College of General Practitioners (ACGP) which was formally founded in 1958. This new College joined the state based faculties. State based faculties remain a key part of the modern day function of the RACGP.
Recognition of general practice as a medical specialty
In modern Australia, general practice is listed by the AMC as a medical specialty and the RACGP as the specialist college responsible for assessment, as endorsed by the Medical Board of Australia inaugurated in 2010.[10][11] Yet, on further examination of how general practice is considered across the nation, some of the now-defunct state-based Medical Practitioners’ Boards such as Victoria, Queensland and South Australia, did not consider general practice a medical specialty and general practice qualifications, such as the Fellowship of the Royal Australian College of General Practitioners (FRACGP) were not registerable qualifications. The practical implication of the nationalisation of medical registration on the status of general practice as a medical specialty may be unclear.
The oddity of general practice in Australia is a lingering and arguably outdated perception that the decision to practise as a GP has low or no standing and status. Comments heard by many GPs including; ‘You are just a GP’ or ‘What do you intend on specialising in?’ reflect something of the community understanding of the general practitioner.
This is not without precedent. The history of the general practitioner shows that GPs in early Australia through to GPs in mid and late 20th century, ‘defaulted’ into general practice having disliked surgical or physician training or having failed exit exams too often.[4]
Also, while Australian general practitioners were part of the creation of the Royal College of General Practitioners and instrumental in highlighting the need for professional and practice standards, Australia was one of the last developed countries to recognise general practice as a specialty. It was 1978 before the National Specialist Qualification Advisory Committee (the predecessor to the Australian Medical Council) recognised general practice as a specialty.[12] In contrast, the United Kingdom had a powerful case for recognition by the late 1960s, and the United States recognised general practice in 1969.[13][14]
Strengthening general practice
The standing of general practice within academic faculties of universities and professionally has undergone a marked increase in recent decades. The RACGP has been a key driver of this shift. The development and consolidation of training programs, standards for training, standards for practice, curriculum of general practice and various evidence based guidelines and publications have occurred internally within the RACGP.[15]
Academic general practice
Demonstrating again the slow shift towards recognition, Australia was late in accepting that general practice should be taught or regarded as a discipline in its own right. The Whitlam government’s Karmel committee into ‘Expansion of Medical Education in Australia’ compromised with departments of ‘community medicine’ – a confusing anachronism that persisted for many years in Australia’s tertiary institutions.[16] The RACGP sought strongly but unsuccessfully that this committee accept general practice into the universities.
Today, general practice is listed or has been added alongside community medicine, highlighting the shift since the early 1970s (e.g. Department of General Practice and Community Medicine Monash University)[17]
Nine foundation professors of ‘Community Practice’ were appointed between 1974 and 1976. Again, Australia lagged behind the US and the UK who appointed their first professors and chairs of general practice and family medicine in 1967 and 1963 respectively.[18]
The foundation professors were:
- Charles Bridges Webb MD FRACGP, Sydney University. Professor of Community Medicine
- Max Kamien MD FRACP, MRCP, FRACGP, DPM, DCH University of Western Australia, Professor of General Practice
- Professor Neil Edwin Carson FRACGP FRACP Professor of Community Medicine Monash University
- Jean Norella Lickliss MD MRACP, FRCP BMedSc DTM&H Professor of Community Medicine University of Tasmania
- Timothy George Murrell MD FRACGP DTM&H CLJ Professor of Community Medicine
- Anthony James Radford FRCP MRCP FRACP MFCM SM DTM&H Professor of Primary Health care Flinders University
- James Geoffrey Ryan BSc FRACGP Professor of community practice University of Queensland
- Ian William Webster MD FRACP Professor of Community Medicine University of New South Wales
- Ross Wharton Webster FRACGP MRACP Professor of Community Health University of Melbourne[18]
Notably, many did not hold general practice qualifications either from Australia or international.
RACGP Awards
Life Fellows
| Life Fellow of the RACGP[19] | Date of award |
|---|---|
| William Arnold Conolly | 20 February 1981 |
| H Stuart Patterson | 18 September 1985 |
| Colin Warden Anderson | 2 September 1987 |
| Herbert Ewan Hamilton Ferguson | 2 September 1987 |
| Harvard Northcroft Merrington | 8 September 1988 |
| John Goulburn Radford | 8 September 1988 |
| Rollo Greenless | 28 September 1989 |
| Bernard Selwyn Alderson | 24 September 1992 |
| William Desmond Jackson | 15 September 1994 |
| John Charles Bampton | 16 October 1996 |
| David Sunter Muecke | 16 October 1996 |
| William Francis Glastonbury | 30 September 1997 |
| David Game | 15 October 1998 |
| Edgar John Hamilton North | 26 October 1999 |
| Richard Geeves | 8 October 2003 |
| Wesley Fabb | 8 October 2003 |
| Peter Doyle | 8 October 2003 |
| Charles Bridges-Webb | 30 September 2004 |
| Neil Carson | 30 September 2004 |
| Max Kamien | 30 September 2004 |
| Jack Marshal | 30 September 2004 |
| James Colquhoun | 30 September 2004 |
| Clive Oswald Auricht | 29 September 2005 |
| Mary Deidre Mahoney | 29 September 2005 |
| John Alfred Stevens | 29 September 2005 |
| Alan (Eric) Fisher | 5 October 2006 |
| Richard (Dick) Gutch | 5 October 2006 |
| Bruce Roberts | 5 October 2006 |
| Elizabeth Jane | 5 October 2006 |
Honorary Fellows
| Honorary Fellow of the RACGP[19] | Date of award |
|---|---|
| Lord Hunt of Fawley | 20 March 1959 |
| Ian Grant | 20 March 1959 |
| William Pickles | 20 March 1959 |
| Donald Alastair Cameron | 19 October 1962 |
| Sir Theodore Fox | 19 October 1962 |
| Robert John Francis Homfrey Pinsent | 24 October 1963 |
| Henry Edward Martyn Williams | 24 October 1963 |
| William Victor Marcus Coppleson | 24 October 1963 |
| Sir Robert Menzies | 9 October 1964 |
| Sir Lorimer Dods | 22 October 1965 |
| Carroll L Witten | 29 May 1966 |
| James T McCollough | 29 May 1966 |
| Sir Norman Nock | 11 October 1967 |
| Sir Thomas Moore Greenway | 1 July 1968 |
| Bruce Toomba Mayes | 10 October 1968 |
| Douglas Gordon | 10 October 1968 |
| George Ian Watson | 2 September 1972 |
| James Lester Grobe | 2 September 1972 |
| Claude Howard Murphy | 2 September 1972 |
| Ronald Diarmid MacDiarmid | 2 September 1972 |
| Donald Ingram Rice | 2 September 1972 |
| Prakash Chand Bhatla | 2 September 1972 |
| Bratham Ramaswarmy Sreenivasan | 26 November 1972 |
| Prince Philip, Duke of Edinburgh | 24 January 1973 |
| Wong Heck Sing | 25 August 1975 |
| Sir Keith Stephen Jones | 15 October 1975 |
| Selwyn Carson | 25 October 1978 |
| James Rupert Magarey | 25 October 1978 |
| David Clements Jackson | 18 October 1982 |
| John George H Refshauge | 11 October 1984 |
| Yvonne Sinclair | 19 April 1986 |
| Reginald Lewis Perkin | 2 September 1987 |
| Bertram Herries Young | 2 September 1987 |
| Victor William Michael Drury | 8 September 1988 |
| Barry Betham Grimmond | 8 September 1988 |
| Thomas Smith Reeva | 8 September 1988 |
| Edward Bassett | 28 September 1989 |
| Robert Edward McKeown | 28 September 1989 |
| Ronnie Woh Mun Yeun | 28 September 1989 |
| Raymond George Ross Moon | 28 September 1990 |
| Peter Baume | 26 September 1991 |
| Manacadu Kumar Rajakumer | 24 September 1992 |
| Peter George Flemming | 6 October 1993 |
| Frank Fry | 15 September 1994 |
| John Derek Richardson | 15 September 1994 |
| Peter CY Lee | 15 September 1994 |
| Neal Blewett | 15 September 1994 |
| Trevor Corey Beard | 28 September 1995 |
| Patrick Augustus Simon Edmonds | 16 October 1996 |
| Sir Gustav Nossal | 15 October 1998 |
| Goh Lee Gan | 8 October 2003 |
| Theres (Tessa) Turnbull | 8 October 2003 |
| W Bruce Connelly | 8 October 2003 |
| Michael Boland | 30 September 2004 |
| Stephen Foo | 30 September 2004 |
| Nat Yuen | 30 September 2004 |
| Fiona Stanley | 30 September 2004 |
| Ngaire Joy Brown | 29 September 2005 |
| Donald Kwok Tung Li | 29 September 2005 |
| Ruby Binti Adbul Majeed | 29 September 2005 |
| Helen Wilhelmina Rodenberg | 29 September 2005 |
| Bruce Louis Walsh sparks | 29 September 2005 |
| Geoffrey Henry James Vause | 29 September 2005 |
| Ian Frazer | 5 October 2006 |
| William Glasson | 5 October 2006 |
| Alfred W T Loh | 5 October 2006 |
| Roger Neighbour | 5 October 2006 |
| Daniel Mahendran Thuraiappah | 5 October 2006 |
Arms
|
See also
- Australian Medical Association
- Infection control
- Occupational safety and health
- Inquiry process into registration and accreditation processes for international medical graduates
- Accreditation process for International Medical Graduates
References
- ^ "Meet the President". Your RACGP - 55th Council. RACGP. Retrieved 9 May 2013.
- ^ "RACGP - organisation".
- ^ "RACGP - management".
- ^ a b Bollen M Saltman D, "A history of general practice", general practice in Australia (2000): Commonwealth of Australia.
- ^ a b "History of Family Medicine" (PDF). American Academy of Family Physicians. Retrieved 24 September 2007.
- ^ a b c Collings J, General Practice in England Today: a reconnaissance. Lancet 1950;i:555-85.
- ^ a b Petchey R, Colling report on General Practice in England in 1950: unrecognised, pioneering piece of British social research? BMJ 1995;311:40–42 (1 July)
- ^ Rose, F, Hunt J, College of General Practice. BMJ 1951;ii;908
- ^ Hunt J, A history of the Royal College of General Practitioners. 1983. Churchill London.
- ^ "Specialist Practice and Relevant Assessing College". Australian Medical Council. Archived from the original on 1 September 2007. Retrieved 28 September 2007.
- ^ "Approved qualifications for specialist registration in a recognised specialty". Medical Board of Australia. Retrieved 2 June 2014.
- ^ 'NSQAC Regulations', National Specialist Qualification Advisory Committee, 1978, Australia.
- ^ "History of the College". Royal College of General Practitioners. Retrieved 2 June 2014.
- ^ "History of the Specialty". Nicholas J Piscano, The American Board of Family Medicine. Retrieved 28 September 2007.
- ^ "RACGP Home Page and website". Royal Australian College of General Practitioners. Retrieved 28 September 2007.
- ^ Karmel P. Report of the Committee on Medical Schools to the Australian Universities Commission. Expansion of Medical Education. Canberra: AGPS, 1973.
- ^ "Department of General Practice and Community Medicine". Monash University. Retrieved 28 September 2007.
- ^ a b Kamien M, A patience of professors. The Foundation Professor of Community Practice in Australia. 1974–2003 MJA 2003;179(1):10–14"A patience of professors. The Foundation Professor of Community Practice in Australia". Medical Journal of Australia. Retrieved 28 September 2007.
- ^ a b RACGP Annual Report 2006-2007
- ^ "The College crest". RACGP College history. Royal Australian College of General Practitioners. Retrieved 9 May 2013.
