Understanding the NTCER and GP trainee employment arrangements for 2022

Whether you are joining the GP training program in 2022 or have been a GP registrar for some time, negotiating your employment agreement with your new training practice can be a daunting task. However, it is an essential part of GP training. 

Join Dr Sama Balasubramanian, GPRA Registrar Advisor, and Dr Andrew Gosbell, GPRA CEO, as they cover the basics of the NTCER and answer your employment question in this webinar. Topics include:

  • Negotiating your employment agreement
  • Not-to-be-missed clauses and items
  • Negotiation checklist

Q&As from the session, not addressed during the broadcast.

Do we get paid when we work additional hours?

YES – this is covered in the NTCER clauses 10.9 and 10.10. Trainees may agree to work additional ordinary hours by negotiation with the practice. The minimum requirement is that additional hours are paid at the registrar’s ordinary hourly rate, regardless of whether the additional hours are during the ordinary span of hours at the practice or after hours and on-call work at the practice or off-site.


Do we need to take leave for the actual examination date?

You may need to do this, depending on your roster and the dates of your exams. Have a discussion about any leave requirements you might need with your supervisor and/or practice manager well in advance of the exam dates.


Can you please explain the difference between getting paid in billings and being paid in receipts? I am not sure if I understand.

Billings are what you request to be paid at the time a service has been provided. Receipts are the actual payments that are received by the practice as a result of processing these billings. Keep in mind that billings are recorded immediately, whereas there will be some delay calculating receipts depending on when patients or organisations such as insurance companies actually pay their bill. This is reflected in the NTCER clause 11 whereby the practice has to supply the registrar with details of any outstanding receipts upon termination and ensure that the percentage of any of these receipts subsequently received are forwarded to the registrar at 3 months post-termination, and at 6 months post-termination.

So being paid via receipts means that your income can be spread out over a longer period and you may also find that you have some exposure to bad debts. GPRA recommends, where possible that your percentage is paid via billings rather than by receipts.


How does working in a bulk billing clinic vs a private billing clinic affect my income?

While in general the opportunity for earning a higher income can correlate with working in a private or mixed billing practice, this is difficult to answer precisely because many factors are at play, including your patient load (number of patients seen), the complexity of the consults and the level of private fees being charged to the patient. Bulk billing general practice clinics are common and can provide a valuable and rewarding training experience.


Any recommendation for employment contract review lawyers?

There are a number of legal firms that offer employment advice; however, GPRA does not have any preferred providers of legal advice that we can recommend.


Any tips for negotiating a part-time position? In particular, negotiating your hours and days?

It is worth liaising with your RTO to ensure that training practices that you are considering are comfortable to have GP registrars working part time. It is important to have conversations about hours and days of work with a potential training practice during the interview process, and be clear on what is non-negotiable (e.g. due to child care arrangements) and/or where you can be flexible (e.g. weekend or after hours). It is vital to get the agreed hours and days in writing, preferable in your employment contract, before you commence working at the practice.


What can I do if the training practice says that they don’t negotiate employment contracts with their registrars?

While this is not best practice, provided the training practice fully complies with the minimum, terms in the NTCER then there is not much that you can do – they are an independent private business and cannot be compelled to negotiate. However, a discussion about your employment arrangements should occur and this should be documented in your employment agreement, and you should be able to understand all the clauses in the contract. And this should occur BEFORE you commence working at the practice. When a practice manager or supervisor says they don’t negotiate, what is often implied here is that the practice is not willing to pay you above the minimum percentage and/or use shorter cycle for billings reconciliations than what is described in the NTCER. You should still seek to negotiate and agree on other conditions such as rostering (including expected weekend/AH workload), when you might want to take annual leave, when in-practice teaching occurs, and any other matters that are important to you.

 

For a range of common enquiries and issues with GP trainee employment arrangements, please see the FAQs section of the GPRA website.