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![Page 1: Medical Board Report Work Performance Report for International Medical Graduates IMGs Holding Provisional Registration](https://reader036.fdocuments.in/reader036/viewer/2022081808/55cf8fff550346703ba2264a/html5/thumbnails/1.jpg)
7/21/2019 Medical Board Report Work Performance Report for International Medical Graduates IMGs Holding Provisional Registration
http://slidepdf.com/reader/full/medical-board-report-work-performance-report-for-international-medical-graduates 1/9
Medical Board of Australia Supervised practice for IMGs with provisional registration – Work performance report Page 1 of 9
Work performance report for international medical graduates (IMGs) holdingprovisional registration
Completing this form
This form is to be completed by the IMG (registrant) and their Board approved supervisor/s at intervalsas specified by the Board. This is usually after the initial three month period of employment in theapproved position, at the completion of 12 months and/or at the time of application for renewal ofregistration.
Instructions for the registrant
You should complete this form first. This enables you to identify your strengths and areas for further
improvement.
Using the criteria listed at the top of the columns, complete the form by initialing each box which youbelieve best describes your performance for each statement. Once completed, give the form to yoursupervisor to complete. You must discuss this review with your approved supervisor and co-
supervisors and at the end of the feedback session sign the form before sending it to the Board.
Instructions for the approved supervisor/s
Consult the appraisal criteria listed at the top of the columns and initial the appropriate “supervisor”
box which best describes the performance of this doctor. Consider input from other co-supervisors of
the provisional registrant to ensure that a thorough and accurate assessment is made. The
performance should be compared to the expected performance for this level of position.
You may wish to seek input into the assessment from other clinical and administrative staff (including
previous supervisors/co-supervisors who should be listed on this form), who may be more familiar with
some aspects of the registrant’s performance.
Arrange a mutually agreed time to meet with the registrant and discuss the review.
Complete the ‘addressing weaknesses and development needs’ and the ‘recommendation’ sections.
Both the approved principal supervisor and the registrant being supervised must sign the form at the
end of the feedback session and the form must be sent to the Board.
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7/21/2019 Medical Board Report Work Performance Report for International Medical Graduates IMGs Holding Provisional Registration
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Medical Board of Australia Supervised practice for IMGs with provisional registration – Work performance report Page 2 of 9
Supervision levels
The levels of supervision are designed to ensure that the practice of the IMG is safe. The Board approvesall supervised practice plans and level of supervision at the time of application. Registrants, supervisors
and employers should not deviate from the approved level of supervision without the prior approvalof the Board.
The Board’s levels of supervision are as follows:
Level 1 supervision
The supervisor takes direct and principal responsibility for individual patients
a) The supervisor must be physically present at the workplace at all times when the IMG is providingclinical care.
b) The IMG must consult their supervisor about the management of all patients
c) Supervision via telephone contact is not permitted.
Level 2 supervision
The supervisor shares with the IMG responsibility for individual patients. The supervisor is responsible forensuring that the level of responsibility that the IMG is allowed to take for patient management is based onthe supervisor’s assessment of the IMG’s knowledge and competence.
a) The IMG must inform their supervisor at agreed intervals about the management of individual
patients
b) If the approved supervisor is absent from medical practice, a medical practitioner with general
registration and/or specialist registration must provide oversight.c) Supervision must be primarily in person. Where the supervisor is not physically present, they must
always be accessible by telephone.
Level 3 supervision
The IMG takes primary responsibility for individual patients.
a) The supervisor must ensure that there are mechanisms in place for monitoring whether the IMG ispractising safely
b) The IMG is permitted to work alone provided that the supervisor is contactable by phone
c) The IMG can provide on-call and after hours services.
Level 4 supervision
The IMG takes full responsibility for individual patients
a) The approved supervisor must oversee the IMG’s practiceb) The approved supervisor must be available for consultation if the IMG requires assistance.
c) The approved supervisor must periodically conduct a review of the IMG’s practice.
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7/21/2019 Medical Board Report Work Performance Report for International Medical Graduates IMGs Holding Provisional Registration
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Medical Board of Australia Supervised practice for IMGs with provisional registration – Work performance report Page 4 of 9
B. Performance
CRITERIA
Initial the box under each categorythat best describes the registrant’sperformance
1
Performsconsistentlywell belowthe levelexpected
2
Performsconsistentlybelow thelevelexpected
3
Performsconsistentlyat the levelexpected
4
Performsconsistentlyabove thelevel expected
Clinical Management
Obtains and documents acomprehensive patient history
Registrant
Supervisor
Performs and documents appropriatephysical examination
Registrant
Supervisor
Critically assesses information,identifies major issues, makes timelyand appropriate decisions and actsupon them
Registrant
Supervisor
Requests, follows up and interpretsappropriate investigations and revisesmanagement plans as necessary
Registrant
Supervisor
Recognises and manages appropriatelyemergencies that arise when managingpatients
Registrant
Supervisor
Plans appropriately for the discharge ofpatients (where relevant) includingcompleting a discharge summary
satisfactorily
Registrant
Supervisor
Performs procedures safely and withinhis/her competence and defined scopeof practice
Registrant
Supervisor
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7/21/2019 Medical Board Report Work Performance Report for International Medical Graduates IMGs Holding Provisional Registration
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Medical Board of Australia Supervised practice for IMGs with provisional registration – Work performance report Page 5 of 9
CRITERIA
Initial the box under each categorythat best describes the registrant’sperformance
1
Performsconsistentlywell belowthe levelexpected
2
Performsconsistentlybelow thelevelexpected
3
Performsconsistentlyat the levelexpected
4
Performsconsistentlyabove thelevel expected
Communication
Communicates effectively with patientsand their families
Registrant
Supervisor
Uses interpreters where necessary Registrant
Supervisor
Communicates effectively with othermembers of the health care team
Registrant
Supervisor
Communicates effectively withprofessional colleagues. This includescommunication with general practitionersfor the handover, referral and transfer ofpatients
Registrant
Supervisor
Clearly documents patient care, maintainscomplete and timely medical records/progress reports
Registrant
Supervisor
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Medical Board of Australia Supervised practice for IMGs with provisional registration – Work performance report Page 6 of 9
CRITERIA
Initial the box under each categorythat best describes the registrant’sperformance
1
Performsconsistentlywell belowthe levelexpected
2
Performsconsistentlybelow thelevelexpected
3
Performsconsistentlyat the levelexpected
4
Performsconsistentlyabove thelevel expected
Professionalism
Shows compassion for patients andsensitivity to their culture, ethnicity andspiritual issues
Registrant
Supervisor
Exhibits high standards of moral andethical behaviour towards patients,families and colleagues including anawareness of appropriate doctor/patient
boundaries
Registrant
Supervisor
Able to recognise limitations in his/herpractice and request assistance whennecessary
Registrant
Supervisor
Shows honesty at all times in their work,puts patient welfare ahead of personalconsideration and accepts responsibilityfor own actions
Registrant
Supervisor
Known the limits of own competence andfunctions within those capabilities, seeksadvice and assistance when appropriate,accepts feedback
Registrant
Supervisor
Shows a resourceful attitude towardscontinuing education to enhance qualityof care; participates actively in a CPDprogram
Registrant
Supervisor
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7/21/2019 Medical Board Report Work Performance Report for International Medical Graduates IMGs Holding Provisional Registration
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Medical Board of Australia Supervised practice for IMGs with provisional registration – Work performance report Page 7 of 9
CRITERIA
Initial the box under each categorythat best describes the registrant’sperformance
1
Performsconsistentlywell belowthe levelexpected
2
Performsconsistentlybelow thelevelexpected
3
Performsconsistentlyat the levelexpected
4
Performsconsistentlyabove thelevel expected
Safe Practice
Demonstrates knowledge of commontherapeutic agents, uses, dosages,adverse effects and potential druginteractions and ability to prescribesafely
Registrant
Supervisor
Demonstrates knowledge of infectioncontrol principles, and safe practice inrelation to blood borne infections, in
patient care
Registrant
Supervisor
Recognises and correctly reportsadverse incidents
Registrant
Supervisor
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7/21/2019 Medical Board Report Work Performance Report for International Medical Graduates IMGs Holding Provisional Registration
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Medical Board of Australia Supervised practice for IMGs holding provisional registration – Work performance report v1.1 Page 8 of 9
C. Comments and future development plans
Strengths
Weaknesses
List the issues to be addressed – i.e. addressing weaknesses and development needs
(The principal supervisor must complete this section)
Issue Actions/Tasks to address issue
(including time frame)
Review Date
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Medical Board of Australia Supervised practice for IMGs holding provisional registration – Work performance report v1 1 Page 9 of 9
D. Recommendations
Recommendations (to be completed by the Board-approved principal supervisor)
Is the registrant suitable for ongoing registration? Yes No
Signatures
Registrant’s Signature: Date:(day/month/year)
Registrant’s Name:
(please print)
Principal Supervisor’s Signature: Date:
(day/month/year)
Principal Supervisor’s Name: (please print)
If relevant, co-supervisor’s signatures
Co-supervisor’s Signature: Date:
(day/month/year)
Co-supervisor’s Name:
(please print)
Co-supervisor’s Signature: Date:(day/month/year)
Co-supervisor’s Name:
(please print)