So what do GPs and GP Registrars earn? How many hours do you work a week on average? These are questions all of us contemplate when choosing a specialty training career, but the answer, especially in GP-land, may not be so easy to come by. This article outlines some basic facts and minimum terms and conditions and then includes some real examples of what GP Registrars have reported earning.

GP Registrars are paid by the practice in which they work. Their attachment to that practice depends on the presence of an accredited GP Supervisor, who acts as a mentor to the Registrar and provides face to face teaching during the GP terms. The practice is subsidised to pay the Registrar to attend a defined number of on site teaching sessions and off site educational sessions which are run by the Regional Training Provider. This means that all GP registrars have paid, protected education time in General Practice during their training.

Full-time Registrars work a minimum of 38 hours/week. This includes education time and administration time. The actual hours of consulting (seeing patients) are usually 27-33 hrs/week. This can vary, especially in rural areas.

Remuneration is really determined by how many patients are seen and whether there is bulk billing or private billing. The GP Registrar can negotiate an hourly rate of pay and/or payment of a percentage of gross billings generated.

GP Registrars are guaranteed National Minimum Terms and Conditions (NMT&C) of employment as agreed by GPRA (General Practice Registrars
Australia) and NGPSA (the National General Practice Supervisors Association). For each stage of training, there is a minimum salary/hourly rate of pay OR the Registrar is paid a minimum of 45% of gross billings (whichever is greater). In 2006, Basic term Registrars (first six months of General Practice) earn a gross minimum of $60 084 p.a. ($1155.46/week 30.41/hr). In the Advanced term, this is $75 745 p.a. ($1456.63/ week or 38.33/hr). This rate is indexed and increases annually by 2.5%. In subsequent terms, GP Registrars negotiate their own salaries/ percentages and terms (although in some regions this is also protected by a minimum).

There have been many changes to Medicare rebates recently which have improved GP remuneration. These include an increase from 85% to100% of the Medicare schedule fee for rebates for bulk-billing and additional bonuses for bulk-billing in areas of doctor shortage.

Once settled into their new practice, most registrars would see 3-4 patients/hour and be entitled to 45% of gross billings. Most of these consults are likely to be level B (also known as item number 23) which equates to <20 mins of consulting time. A standard bulk-billed level B GP consult is rebated by the Medicare Benefits Schedule to the value of $31.45. Private billing for a level B consult may range from $40–60 (the patient then claims back $31.45 from Medicare). Longer consults for more complex problems are rebated at higher rates (level C, <40 minute consult, $59.70; and level D, at least 40 min consult, $87.90).

So once established, a GP Registrar may bill anywhere from about $100-$240 per hour of patient consulting. They would then be entitled to receive 45% of billings = $45-$108/hr = $1215-$2916/ week. As an employee, the GP Registrar is also entitled to 9% superannuation and four weeks annual leave which is paid for by the practice.

Those GP Registrars who do on-call and hospital VMO work also earn a minimum of 55% of the hospital billings.

Some Registrars work in salaried practice, especially ADF registrars, those in Aboriginal Medical Services and some rural and remote hospitals that also provide GP services to the community. Below are some approximate examples of the real amounts earned by registrars in 2003-2006 (before tax). Please note in the example given below that procedural work and hospital work provide significant additional income compared with solely practicebased consulting. Also longer hours of work, more common in rural and remote settings, will attract higher incomes.

Training stage	Location	Practice Style % of Billings pd	On-Call	Avg Patient Consult. Hr/wk	Hrly ($)	Wkly ($)	Annual ($)
Basic	Outer metro	45%, Mix Billing	N/A	26-30 hrs	$37	$1,131	$58, 828
Advanced	Remote	Salaried Hosp. based Med. Officer, proc.wrk	1 in 2-3	60-80 hrs	N/A	$2,658	$138,262
Subsequent	Rural	50% Mix Billing, hosp. admit rights, proc. Wrk (anaes)	1 in 6 7-10 on call	28-30 hrs	$66	$2,670	$138,860
Locum (immed, after comp. training)	Rural	60% Mix Billing, hops. Admit rigts	N/A	38-40 hrs	$90	$3,630	$188,777

So overall, GP remuneration is now reasonable ,with recent changes to Medicare. It is important to note that working in rural areas, doing procedural work and working as a hospital VMO tend to attract significantly higher incomes. However even in urban areas, once established in their practices, GP Registrars often earn more than what is stipulated
in the NMT&C document. All this with flexible hours and choice of practice style too.