The future of general practice

GP FirstA story of success

Taking a fresh look atgeneral practice

Breathing new life into general practice

Breathing new life into general practice

General Practice reGistrars australia2

media releaseaBB114

/07

GP First a story of success

GP FIRST has successfully ignited the conversation about general practice as a career specialty of choice in universities and hospitals around the country.

the program was designed to increase the supply of doctors entering general practice and to enhance the understanding of the integration between primary and secondary healthcare amongst medical students and junior doctors. It encompasses three key workforce programs – General Practice student Network (GPsN), Going Places Network (GPN) and first Wave scholarship program (fWsP). originally launched by the Hon. tony abbott MP, the program has been supported by every subsequent health minister.

GP FIRST A STORY OF SUCCESS 3

the networks are managed by GPra, the only organisation in australia with a cohesive vertically integrated network servicing medical students, junior doctors and GP registrars, and providing the pipeline for transition into aGPt.

GP FIRST – supplying candidates for AGPT

11% 2011

oF AGPT APPlIcAnTS weRe FRom GP FIRST

oF AGPT APPlIcAnTS weRe FRom GP FIRST

2012

25.6% oF AGPT AccePTAnceS weRe FRom GP FIRST

2013

35%

By 2017 over 80% of all AGPT applicants will come from GP First networks.

Fastest-growing medical network in the country 6 years in a row

3,000

6,000

9,000

12,000

15,000

GP FIRST MEMBERS

2007 2008 2009 2010 2011 2012 2013*

192

2,469

4,049

6,312

8,164

11,400

14,155

*At August 2013.

GPSN started in October 2007. GPN started in 2009 as a pilot in 3 states followed by national roll-out in mid 2010.

64% oF All cuRRenT medIcAl STudenTS ARe membeRS oF GPSn

32% oF All PRe-vocATIonAl docToRS ARe GPn membeRS

Developing future leaders for general practice

the networks are run by a number of highly committed volunteers, and provides its members with opportunities for leadership and involvement in policy development. since inception, these networks have produced over 120 potential GP leaders each year – that’s over 600 in total.

Value for money

GP first is extremely cost-effective. for a $77 per individual investment the network reaches a target audience of 17,000 medical students and 10,000 junior doctors, offering multiple touch points through print media, online campaigns, events and scholarships.

GP first depends upon its passionate, committed volunteer workforce of over 100 individuals. a highly conservative estimate of the combined contribution of these individuals is estimated at 2,500 days of work per annum, presenting a free work output of 20,000 hours per annum valued at over $500,000 per annum.

compared to other programs, the value for money that this program represents speaks for itself, for example, if compared with PGPPP

COSTS ($m) MARKET PENETRATION

PGPPP $54.5mGP FIRST $2.1m

PGPPP 975 Jr. doctorsGP FIRST 14,155 members

54.5

2.1

14,155

975

PGPPP has been operational since 2007 and in 2012 only 25% who completed the placement later joined the AGPT (source: Mason Review, 2013). In comparison, in 2013 35% of acceptances in AGPT were from GP First.

General Practice reGistrars australia4

GeNeral PractIce studeNt NetWork

launched in october 2007 with a funding grant from the commonwealth via the then Health Minister the Hon. tony abbott MP, the network is a student-driven peer-to-peer engagement program that has created a space for the conversation about the breadth and depth of general practice.

GPSn offers direct face-to-face engagement with the student cohort

1,000

2,000

3,000

4,000

5,000

6,000

7,000

ENGAGEMENT WITH STUDENT COHORT

YEAR2007 2008 2009 2010 2011 2012

0 0 36 60 72 85 101

1,000

2,500

3,500

5,000

6,500

EVENTS HELDEVENT ATTENDANCES

GPSn membership

2,000

4,000

6,000

8,000

10,000

12,000

MEMBERS

YEAR2007 2008 2009 2010 2011 2012 2013*

*As of August 2013.

121

2,230

3,704

5,838

6,865

8,960

10,763

Strong return on investment

GPra continues to provide value for money by through financial contribution.

100

200

300

400

500

600

TOTAL FUNDING ($’000)

YEAR2007 2008 2009 2010 2011 2012 2013

45

36 48

327.5

510 500

575560

GPET FUNDING GPRA FUNDING

28 23

13 25

GP FIRST A STORY OF SUCCESS 5

“From a small idea by one medical student, who wanted to ensure that every student was being provided with an opportunity to explore

the possibilities of a career as a general practitioner, to the thriving network it is

today, GPSN is an exceptional initiative.”

Professor michael Kidd Am

cost allocation per member continues to reduce

50

100

150

200

250

300

350

COST ALLOCATION ($ per member)

YEAR2007 2008 2009 2010 2011 2012 2013

0

313

130

8773

6351

Breathing new life into general practice

Æ GP first has been the catalyst for change around the way general practice is discussed in universities.

Æ For the first time in Australian history there is a genuine conversation about general practice in medical schools.

Æ the program has shifted the perceptions of an entire generation, and started a conversation about the real world of general practice.

Æ energised by a passionate volunteer student workforce dedicated to promoting general practice and creating strong mentoring and professional relationships between medical students, junior doctors, GP registrars and GPs, the program is:

– raising the profile of regional and rural general practice – developed and maintained a strong active presence at

every medical school campus across australia.

“GPs are critical to our health system. Establishing mentoring between registrars and medical students should promote the discipline in the same way that a good clinical placement in general practice does.”

The Hon. Tony Abbott mP

General Practice reGistrars australia6

Strong growth in scholarships

30

60

90

120

150

NUMBER OF SCHOLARSHIPS

YEAR2008–09 2009–10 2010–11 2011–12 2012–13

24

52

73

102

121

Scholarship funding

100

200

300

400

500

600

TOTAL FUNDING ($’000)

YEAR

116

242* 300

375

510

GPET FUNDING GPRA FUNDING

72

72.85

55

2008–09 2009–10 2010–11 2011–12 2012–3

*2009-10 70% of the cost was supported by rtPs.

GPra continues to substantially support this program through other externally sourced funding.

fIrst Wave scHolarsHIP ProGraM

first Wave scholarship Program (fWsP) is designed to offer early positive exposure to general practice, enabling students to better understand where general practice sits in the context of the healthcare system and holistic patient care.

this program was funded entirely by GPra for 2009 and 2010 and then gained support from the minister’s office and from doHa. the program was formally funded via GPet.

“My placement reinforced the many positive aspects of general practice, such as the variety of clinical practice and the ability to pursue a special interest in an area of medicine at the same time.”

Second year medical student, uwA

20

40

60

80

100 %

PARTICIPATING UNIVERSITIES & RTPS (%)

YEAR2008–09 2009–10 2010–11 2011–12 2012–13

1515

63

7065

7570

100

70

95

PARTICIPATING RTPS %PARTICIPATING UNI %

GP FIRST A STORY OF SUCCESS 7

Average cost per scholarship continues to reduce

1,000

2,000

3,000

4,000

5,000

6,000

AVERAGE COST PER SCHOLARSHIP ($)

YEAR2008–09 2009–10 2010–11 2011–12 2012–3

4,8334,653

5,287*

4,7354,340

*2010–11 involved additional setup costs as the program moved mainstream.

Economies of scale for this program are achieved when running > 80 scholarships per annum

Program impact

this program has a long lead time to conversion. students undertake the scholarship in first or second year of study. Participant surveys reveal that this program has significant impact on career decisions.

Over 92% say this was extremely useful in assisting them with their future career choice.

over 77% say they are more likely to consider GP as a career after completing this scholarship.

“Through First Wave I experienced the sense of community of rural

medicine, which has influenced my decision to chose rural medicine.”

First year medical student, university of melbourne

conversion to AGPT

despite the fact that the program is still young, we are already able to show significant conversion.

total students completed in 2008–10 76

total who have graduated as of 2012 35

Have applied into GP training 9

are intending to apply in 2014 2

are still undecided but considering 10

this presents a conversion of 31% with another 28% still considering. these conversion rates are expected to further increase as the quality of the program and selection processes have improved over the years.

In comparison, only 25% of PGPPP applicants in 2012 went on to apply into aGPt (source:Mason review, 2013).

the average cost of one First Wave scholarship is less than one Fte week of PGPPP.

there is a substantially higher conversion rate at a fraction of the cost, providing great value for money. GPra is certain that this conversion can be translated to rural and aboriginal health settings with appropriate adjustment of the program.

Strong stakeholder support

Æ 100% of departments of general practice within the universities actively support this scholarship program.

Æ over 70% of rtPs actively support and participate in this program. they are building direct links with their future applicants.

Æ the program encourages registrars to become medical educators and supervisors by taking on medical students.

Æ this is now regarded as a highly prestigious scholarship and students now aspire to be first Wave scholars.

Æ the program changes students perceptions of the nature of general practice and begs the question, “are you good enough to be a first Wave scholar?” one in three miss out and the process is highly competitive.

General Practice reGistrars australia8

GoING Places NetWork

Introducing general practice into hospitals

Æ the existence of GPN gives GP educators access to teach in the hospital system.

Æ GPN puts general practice firmly on the hospital educational programs.

Æ facilitates linkages between the rtPs and the hospital system.

Æ GPN is the only national network in the hospital system with a focus on general practice.

the Going Places Network (GPN) is a peer-to-peer network of GP ambassadors based in 65% of teaching hospitals around australia. the network provides ongoing exposure, support and information about opportunities in GP through the hospital years. Piloted in three states under the name “GP compass”, the program was officially launched in 2009 and has been hugely successful with strong support from both doHa and the Minister’s office. The GPN is now firmly embedded in the hospital landscape and will become the fastest-growing network in the next 3 years.

Member growth

500

1,000

1,500

2,000

2,500

3,000

3,500

MEMBERS

2007 2008 2009 2010 2011 2012 2013*

71239

345474

1,299

2,440

3,392

*At August 2013.

this is still a young program and, whilst gaining substantial traction and recognition, it has not yet attained maturity. as GPsN members graduate and become members of GPN, this network is set to double in size over the next 3 years.

GPN operates in 65% of teaching hospitals in the country, with an ability to expand to 100%, subject to funding.

the GPN will expand over the next few years to provide an engagement platform with over 80% of all junior doctors in the country and is an excellent peer-driven network, offering a one-on-one engagement in an environment that has historically been very difficult to penetrate. Gradual investment in this initiative will ensure that GP remains front of mind when people are making their career choices.

“As an international medical graduate I felt very confused by what steps I had to take to practice as a GP in Australia. My GP Ambassador was available to help answer my questions and point me in the right direction.”

Junior doctor, Townsville

50

100

150

200

EVENTS

2007 2008 2009 2010 2011 2012 2013

0 010 12

120

171TBC

GP FIRST A STORY OF SUCCESS 9

riGHt PeOPle. riGHt sKills. riGHt lOCatiONs. riGHt COsts.

the Health Workforce 2025 report and the Mason review highlight the issue that whilst we may have enough doctors by 2025, they are going to be in the wrong locations and with the wrong skills. GP first is the only vertically integrated program that has the capacity, focus and ability to reach and influence the next generation of doctors coming through.

Within the context of GP training, the current oversupply of applicants is a short-term situation.

the training program is expected to expand to 1,800 over the next 4 years. To fill this with quality AMG applicants we need over 2,500 candidate applications per annum.

this will require almost 70% of the graduating cohort of 3,600 graduates to apply into GP training. GP first, through its already strong networks, will have a critical ongoing part to play in this supply if it is to be consistently sustained.

In addition to promoting general practice, we envisage that this program will expand to address other key areas of workforce maldistribution.

new Focus for GP FIRST

GP first will expand beyond simply promoting careers in general practice and will bring a new focus to include targeted initiatives around aboriginal and torres strait Islander health, promotion of the rural and remote workforce and support for IMG/otds. It will also look to maximise the opportunities for engagement between GPsN and GPN members in these expanding areas.

POSITIVE EXPOSURE TO

RURAL HEALTH

PROMOTE GP CAREERS

POSITIVE EXPOSURE TO ABORIGINAL

HEALTH

SUPPORT FOR IMG’S

Aboriginal and Torres Strait Islander health

the GP fIrst program currently includes over 14,000 members, some of which are aboriginal and non-aboriginal individuals. as such, GPra has created a framework to deliver targeted outcomes in this space and build on existing initiatives such as the Indigenous GP registrar network currently funded by GPet. the key objectives will be to

Æ increase the supply of and support for aboriginal and torres strait Islander doctors

GP First future dIrectIoN

dIRecT PoSITIve exPoSuRe

Indigenous first Wave scholarshipsPublications and online informationevents and speakerscampaignscultural safety training online

PASToRAl cARe

vertical integration of indigenous networks – IGPsN, IGPN and IGPrNcross linkages with aIda and NaccHoIGPrN chair and rlo network support

menToRInG

links with aIda and racGPsupport from close the Gap subcommitteeGPrMeN and GPrsNet and rlosexam support

Æ encourage non-aboriginal doctors to work in aboriginal and torres strait Islander health

Information and links to local communitycultural mentorsclose the Gap campaignreconciliation action Plans collaboration planscultural safety training

culTuRAl AwAReneSS

Future PlaNs

General Practice reGistrars australia10

Rural and remote health

through a change of emphasis across the various elements of the GP first program, there will be increased opportunities for early, positive exposure to rural and remote communities.

the review of the programs has indicated that building a targeted exposure to rural opportunities across the medical student and junior doctor market segments is not too onerous. key mechanisms to build this into the program include:

Æ targeted regional collaboration with existing initiatives such as rural clubs, rural clinical schools , workforce agencies, training providers etc.

Æ realigning core activities of both networks to introduce an element of rural exposure.

Æ shifting focus of communication and marketing channels to ensure rural exposure.

the framework below outlines the broad promotional components of the program. these activities are likely to have only a small budgetary impact since some are already incorporated. New items such as regional coordination and quarantining scholarships for rural locations will have some additional costs but these will also improve the overall quality of the GP fIrst program.

mediCal studeNts

Promote rural opportunities via web, enews, publications

and campaigns

Partnership with rural clinical schools

and rural clubs

At least one event per annum with strong

rural focus

First wave Scholarships to expand in rural and

indigenous areas

JuNiOr dOCtOrs

Promote rural opportunities via web, enews, publications

and campaigns

Peer support network for rural community placement program

network events to feature rural opportunities

ImG support network and targeted information

resources

GP First future dIrectIoNcontinued

GP FIRST A STORY OF SUCCESS 11

FOr mediCal studeNts

SuPPoRT To dIRecTIonS To locAl clubS

exec & councIl

nATIonAl cAmPAIGnS & communIcATIonS

SubcommITTeeS: RuRAl, cloSe THe GAP, PolIcy, communITy

PeeR-To-PeeR AcTIvITy

AmbASSAdoR PRoGRAm

oRGAnISe on-cAmPuS PRomoTIon, dISTRIbuTIon oF collATeRAl

AcceSS To unIveRSITIeS & lInK To GP dePARTmenTS

one cAReeR evenT

STudenT club AcITIvITIeS

one AboRIGInAl HeAlTH evenT

one RuRAl evenT (PARTneR wITH RuRAl clubS)

THRee PeR unIveRSITy (100 ToTAl)

Fw ScHolARSHIPS

1ST–4TH-yeAR STudenTS

50% RuRAl RA3 PluS locATIonS

one PeR unI GRowInG To THRee PeR unI

IndIGenouS Fw ScHolARSHIPS

3Rd- And 4TH-yeAR STudenTS

TARGeTed exPoSuRe To AboRIGInAl HeAlTH

collAboRATIon wITH AIdA & unIveRSITy dePARTmenTS

IdenTIFy menToR FoR eAcH club

IGPSn neTwoRK

culTuRAl TRAInInG

menToRInG PRoGRAm FoR AboRIGInAl med STudenTS

connecTIon To locAl communITy

SuPPoRT To GeT THRouGH medIcAl ScHool

PublIcATIonS & oTHeR TARGeTed conTenT

“Being a member of the Going Places Network has given me the opportunity to explore the world of general practice before committing

myself to the training program by networking with GPs in my area and other junior doctors

with similar interests. Without the Going Places Network I would probably still be in limbo as

to my future training direction.”

AGPT applicant 2013

Key

Green – existing programsorange – enhancements to programsred – new opportunites

Key features of GP First into the future

the future direction of GP first is broken up into three broad areas:

1. strengthening existing initiatives (green)2. Modifying scope of existing initiatives to better target resources (orange)3. New initiatives (red)

General Practice reGistrars australia12

GP First future dIrectIoNcontinued

FOr JuNiOr dOCtOrs

PeeR-To-PeeR AcTIvITy

AmbASSAdoR PRoGRAm

AcceSS To HoSPITAl SySTemS

dISTRIbuTe collATeRAl & meSSAGeS FoR GPSn, GPeT & RTPS

cReATe STATe AmbASSAdoR Role To SuPPoRT oTHeR AmbASSAdoRS

PASToRAl cARe

HoSPITAlITy oRIenTATIonS / TeAcHInG SeSSIonS

evenTScAReeR InFoRmATIon evenTS

AGPT SelecTIon InFo webInARS

clInIcAl SKIllS (RuRAl/AboRIGInAl FocuS)

PRomoTIon & InFoRmATIon ReSouRceS

PGPPP SuPPoRT

AGPT SelecTIon InFo webInARS

PeeR SuPPoRT neTwoRK FoR PARTIcIPAnTS

PASToRAl cARe

TARGeTed InFoRmATIon ReSouRceS

ImG neTwoRK

lInK To oTdneT

menToRInG & PeeR SuPPoRT

PRomoTe RuRAl & AboRIGInAl HeAlTH

TARGeTed SuPPoRT To APPly InTo AGPT

IGPn neTwoRK

PASToRAl cARe & lInK To IGPSn & IGPRn

lInK To oTHeR non-AboRIGInAl menToRS

PublIcATIonS & oTHeR TARGeTed ReSouRceS

culTuRAl TRAInInG

lInKS To locAl communITy

“This program fills a critical gap by providing targeted advice related to

general practice to junior doctors at a key time in their life when they are at the cusp of making the final choice.”

Junior doctor, RPA

Key

Green – existing programsorange – enhancements to programsred – new opportunites

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GP FirstA story of success

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