Supervision Requirements

Supervision is an essential component of the GP training program. The underlying rationale is that registrars are training to be GPs and, at the end of their training, they are certified as being competent to practice as an independent GP. The implication is that, during training, they are not yet ready for independent practice and require supervision. Proper supervision is essential to protect patients, the practice and the supervisor (as both practice and supervisor have some legal responsibility), as well as the registrar.

The fundamental requirement is that the GP supervisor must be available at all times that the registrar is undertaking clinical work. The supervisor does not have to be physically standing next to the registrar but they do have to be available. The RACGP standards for teaching practices state that the supervisor must be on-site for a minimum of:

• 80% of the time during GP Term 1 (though they should ideally be available 100% of the time in the first month)
• 50% of the time during GP Term 2, and
• 25% of the time during GP Term 3 or later terms

When the supervisor is off-site (either in-hours or after-hours) they must be available by phone and must be able to attend in person if a situation arises that requires backup.

This is quite onerous - but the supervision load can be shared. This can be done in a number of ways.

1) Having two accredited GP supervisors in the practice.
This allows sharing of the supervision load and cover for after-hours, supervisor leave etc. This is the preferred option.

2) Delegation to other GPs in the practice.
Supervision can be delegated to other GPs in the practice who are not officially a supervisor (ie not accredited as a supervisor) as long as:

• they are vocationally registered as a GP
• the supervisor considers that they are suitable
• they are willing to take on this role

If this is to be for an extended period while the supervisor is absent (i.e. more than two weeks) one delegate GP must apply to be accredited as a supervisor.

3) Delegation to a locum or a GP outside of the practice.
This is quite tricky but may be the only option for a solo GP supervisor. The disadvantages are that:

• the GP/locum may not be familiar with the registrar, the registrar’s level of training and the registrar’s competency in different areas
• the GP/locum may not be familiar with the training program and the requirements for supervision
• the registrar may not know the GP/locum and may be reluctant to seek advice or assistance in situations where they would normally approach their supervisor

The requirements in this situation are that:

•  the delegate GP/locum is vocationally registered as a GP
• they are willing to take on the supervisory role
• the supervisor explains the requirements for supervision
• the supervisor considers that they are suitable
• the arrangements are negotiated with the registrar
• the delegation must be approved in advance by Valley to Coast

If this is to be for an extended period while the supervisor is absent (i.e. more than two weeks) the delegate GP must apply to be accredited as a supervisor.

It is essential that the registrar always knows who to contact for supervision and how to contact them. This is particularly important for after-hours work, rural hospital work, or if the supervision is delegated.