UPDATE on COVID-19 for GP trainees—your FAQs answered
Content last updated 24/09/2020.
THE COVID-19 pandemic is impacting education and training for all GP trainees. While the scope and size of these changes are unlike any other faced by GP training previously, GPRA is here to support all GP trainees in the face of uncertainty and change.
We are here to support you:
- Responding as quickly as possible to your enquiries
Contact us via firstname.lastname@example.org While we are receiving a significant increase in enquiries, we are endeavouring to provide you with a response ASAP.
- Providing updates on our online FAQs
Visit this page regularly for the latest on how COVID-19 is effecting GP training
- Sending out eNewsletters as new information is made available
Make sure your email address current by updating your membership information.
This pandemic is a rapidly evolving landscape and the latest information, policies and procedures may change. We will keep you updated on any changes and, as always, we are here to help you over the phone and via email.
Have the temporary MBS telehealth items been extended and is there more information available?
(24 September 2020)Expand
The following is from the Department of Health:
Extending until 31 March 2021, temporary MBS telehealth items have been made available to help reduce the risk of community transmission of COVID-19 and provide protection for patients and health care providers.
The temporary MBS telehealth items are available to GPs, medical practitioners, specialists, consultant physicians, nurse practitioners, participating midwives, allied health providers and dental practitioners in the practice of oral and maxillofacial surgery.
It is a legislative requirement that GPs and Other Medical Practitioners (OMPs) working in general practice can only perform a telehealth or telephone service where they have an established clinical relationship with the patient. There are limited exemptions to this requirement.
GP and OMP COVID-19 telehealth services are eligible for MBS incentive payments when provided as bulk-billed services to Commonwealth concession cardholders and children under 16 years of age.
The temporary GP and OMP bulk billing incentive items for patients who are vulnerable to COVID-19 and the temporary doubling of all Medicare bulk-billing incentive fees ceased as of 1 October 2020.
A service may only be provided by telehealth where it is safe and clinically appropriate to do so.
For all the fact sheets please click here.
I have a question about the temporary MBS telehealth items, is there more information available?
(11 August 2020)Expand
To ensure continued access to essential Medicare rebated consultation services for Australians, new temporary MBS telehealth items were introduced by the Department in March 2020.
These items and the requirements for their use have been evolving as the situation itself changes. To support practitioners in effectively using these new telehealth item numbers the department has developed a ‘Telehealth Items Guide’ (the Guide).
The Guide provides practitioners with a comprehensive suite of supporting information on the requirements associated with these temporary items, including case studies and examples of their application in a clinical setting, and frequently asked questions (FAQs).
I haven't been with my training practice for 12 months, am I still able to provide Medicare-subsidised telehealth services under the new Telehealth Stage 7 arrangements?
(23 July 2020)Expand
From July 20, there needs to be an existing and continuous relationship with the GP practice for patients to receive Medicare-subsidised telehealth GP services*. Requiring COVID-19 video and telephone services to be linked to a patient’s usual GP or practice supports longitudinal, person-centred primary health care, associated with better health outcomes.
For GP trainees this means that the patient must have received a face-to-face service with the trainee or with any other doctor (i.e. GP or GP trainee) at the same practice within the last 12 months.
So where a patient is new to the GP practice, they need to establish a face-to-face relationship (i.e. have an in person consultation with the GP trainee or another GP at the practice) before being able to access Medicare-subsidised telehealth.
* This new requirement will not apply to patients living in areas of Victoria subject to new stage 3 restrictions. Also there are exemptions for certain other patient cohorts.
Are there training extensions available to those on the RACGP PEP Pathway?
(28 May 2020)Expand
In response to the impact of COVID-19 on PEP participants, the RACGP is offering a PEP COVID Term Extension.
This is a three-month program extension available to current PEP participants regardless of their length on the program, to enable the participants and their Training Organisations additional time to work towards program requirements.
The form for participants to apply for the PEP COVID Term Extension can be found on the RACGP website, in the PEP portal.
For more information, contact Gilbert.Hennequin@racgp.org.au on 03 8699 0916
What help is available to GP trainees who are NOT on the AGPT program pathway?
(14 May 2020)Expand
The Department of Health will grant an automatic 6-month extension of s3GA placements and 19AB exemptions expiring from 1 May 2020, including extension of locum placements.
No application form is required for these extensions, and these extensions will be processed on a month-by-month basis (approximately 6 weeks in advance of expiry). All extensions will be confirmed with each doctor via letter or email.
The 19AB requirement to work in a Distribution Priority Area location for a period of 10 years (the 10-year moratorium) remains, however those doctors who already have exemptions which are expiring will be able to continue working in their current jobs.
The measures apply to 3GA programs including:
- RACGP Practice Experience Program (PEP)
- ACRRM Independent Pathway
- More Doctors for Rural Australia Program (MDRAP)
- Approved Medical Deputising Services (AMDS)
More detail and conditions attached to these changes can be viewed in this table.
- Department of Health - COVID-19 extensions for section 19AA
- Department of Health - COVID-19 extensions for section 19AB
The RACGP have announced that they are going to replace the OSCE with a new clinical exam. What does this mean?
(8 May 2020)Expand
Due to restrictions surrounding the COVID-19 pandemic the RACGP has been unable to hold the OSCE in its current format, with the requirement for several hundred examiners, candidates and support staff to gather in confined spaces no longer possible. Therefore, as previously announced, the 2020.1 OSCE has been postponed. Subsequent to this, the RACGP has taken the opportunity to expedite plans to replace the OSCE with a new clinical exam in 2021.
An transitional clinical exam will be held in November 2020. Passing this assessment will count towards requirements for Fellowship just like passing the OSCE would.
The completely new Fellowship clinical exam will commence from March 2021. This assessment will better test competency to work unsupervised in general practice than the current OSCE format.
There will be no change to the clinical assessment fees in 2020 or 2021.
GPRA is acutely aware of how unsettling this is for GP trainees and the high level of anxiety for doctors who had been preparing to sit the OSCE in 2020. We have continued to raise these concerns with the RACGP. Since the announcement of the new clinical exam, GPRA has followed up with the College. Initial advice GPRA has received from the RACGP is that the skills that are tested in an OSCE will be broadly the same as for the transitional clinical exam to be held in November 2021, and it is recommended that the best preparation for this exam is practising evidence-informed general practice. GPRA has also received assurances that further information about the format of the 2020 transitional assessment and the new 2021 clinical exam will be provided to us and all GP trainees very soon.
Further information is available on the RACGP FAQ page: https://www.racgp.org.au/FSDEDEV/media/documents/Faculties/GPIT/FAQs-OSCE-changes.pdf
When will the RACGP exams run in 2020?
(8 May 2020)Expand
In March the RACGP Board made the very challenging decision to postpone the 2020 RACGP exams due to COVID-19 situation. This has affected the 2020.1 OSCE and the 2020.2 AKT / KFP and there is a run on effect for the 2020.2 OSCE.
The RACGP is working to ensure there are adequate contingency plans in place for the KFP and AKT exams to occur in October 2020 regardless of social distancing restrictions in place at that time.
The RACGP have announced that they will not be running another OSCE. Instead, a transitional clinical assessment will be held in November before introducing a new clinical Fellowship exam in 2021. More information is here: https://www.racgp.org.au/FSDEDEV/media/documents/Faculties/GPIT/FAQs-OSCE-changes.pdf
Below, is a table outlining the proposed dates for the affected exams:
Will be now held as the transitional clinical assessment.
Enrolments for the November transitional clinical assessment have not yet been re-scheduled. Candidates who are currently enrolled in the May OSCE will be automatically enrolled in the transitional clinical assessment in November 2020.
17 & 18 July 2020
9 October (AKT) and 10 October (KFP) 2020
The content of AKT and KFP exams will not change, and will be exactly the same as the assessments originally scheduled in July. The same standard of performance will be expected in order to pass the exams.
Enrolments: open from 11 May 2020 until 9:00 am, Monday 10 August 2020. Any GP trainee who enrolled in the 2020.2 KFP or AKT when enrolments first opened in March will keep their enrolment, and don’t need to make any changes.
Will be now held as the new clinical assessment.
Enrolments for the new clinical exam in 2021 have not yet been re-scheduled. Candidates enrolled in the 2020.2 OSCE will undertake the new clinical assessment in 2021, and their enrolment will be automatically rolled over.
Is the JobKeeker Payment available to doctors who are on RACGP PEP or ACRRM independent pathway, or working as non-VR GPs?
(4 May 2020)Expand
Doctors on RACGP PEP and ACRRM independent pathway, or working as non-VR GPs are not typically employees (who are employed according to the NTCER) but usually engaged as contractors by their practice. Therefore, as they are sole traders they may be entitled to the JobKeeper Payment scheme under the business participation entitlement, if their turnover has reduced. For more information and eligibility criteria please refer to this website: https://www.business.gov.au/Risk-management/Emergency-management/Coronavirus-information-and-support-for-business/JobKeeper-Payment-for-sole-traders
Note: The Australian Commissioner of Taxation has extended the time to enrol for the initial JobKeeper periods, from 30 April 2020 until 31 May 2020.
Is the JobKeeker Payment available to GP trainees, given that I only started my current training placement in February 2020?
(1 May 2020)Expand
Yes - GP trainees are employed on a fixed-term agreement, according to the NTCER. Advice from the ATO is that employees on a fixed-term contract "are eligible for the JobKeeper payment if they were employed at 1 March 2020 and meet the other eligibility criteria for the JobKeeper payment."
Eligibility criteria include that you are:
- currently employed by the eligible employer (including if you were stood down or erminated)
- either a full-time or part-time employee at 1 March 2020
- an Australian resident
- not in receipt of government paid parental leave.
If your training practice is eligible and chooses to participate in the JobKeeper Payment scheme, they must nominate you, and you must tell your employer that you agree to be nominated as an eligible employee, in order for them to make a JobKeeper claim for you.
For more information see: https://www.ato.gov.au/General/JobKeeper-Payment/Employees/Eligible-employees/
Can my clinic stand me down or reduce my hours in light of the current COVID-19 crisis?
(30 April 2020)Expand
A reduction in a GP trainee’s working hours or a stand down period has significant ramifications in terms of employment and training, and so there should be close consultation between the GP training practice, registrar and the RTO if such measures are being considered by the training practice.
The NTCER does not describe any specific stand down provisions, so unless there is a specific provision in your individual employment contract, under usual circumstances you cannot be stood down or have your hours reduced just because the business is quiet or there isn't enough work: https://www.fairwork.gov.au/pay/pay-during-inclement-weather-and-stand-down#what-is-stand-down
However, from 9 April 2020, the Fair Work Act has been temporarily amended (until 28 September 2020) to support the implementation and operation of the JobKeeper wage subsidy scheme.
The new provisions in the Fair Work Act enable employers who qualify for the JobKeeper scheme, and who are entitled to JobKeeper payments for their employees, to give directions called ‘JobKeeper enabling directions’. In certain circumstances, this means that employers can temporarily:
- stand down an employee (including by reducing their hours or days of work)
- change an employee’s usual duties
- change an employee’s location of work.
Obviously in the current extraordinary circumstances, many GP practices are experiencing a (likely temporary) drop in patient's presenting for face-to-face consults and this is decreasing practice revenues. Hopefully most practices are pivoting to incorporate a telehealth model into their processes, which will help to alleviate this decrease in revenue. GP practices may also be able to take advantage of the new JobKeeper payment provisions to subsidise wages for practice employees, including GP trainees. So if your GP practice does qualify for the JobKeeper scheme, then the new provisions in the Fair Work Act do allow a JobKeeper enabling stand down direction to be given to you.
An employer needs to make sure that such a direction isn’t unreasonable, taking into account all of the circumstances. So for a GP trainee, "all the circumstances" would include the impact of the stand down direction on the registrar's training and so this implies that discussion with the RTO and registrar about these matters occurs as part of the process. A JobKeeper enabling stand down direction must be in writing, and your practice must:
- notify you in writing at least 3 days before giving the direction (unless you genuinely agrees to a shorter timeframe)
- consult with you about the direction
- keep a written record of the consultation.
If you are subject to a JobKeeper enabling stand down direction to not work on certain days or to work for a reduced number of hours, the practice must pay you either the JobKeeper payment (i.e. $1500 per fortnight, before tax) or your usual pay for any hours that you do work – whichever is more. Also note that your hourly base pay rate, as described in the NTCER, cannot be reduced.
Adapted from examples provided on the fair work webpage
Sam is training as a full time GPT1 and her GP training practice has suffered a significant drop off in patient numbers following the coronavirus outbreak. This is significantly affecting the practice revenue. Sam’s supervisor has discussed this with Sam and her RTO, including the need the reduce Sam’s working hours and the effects this will have on Sam’s training.
Sam’s GP training practice qualifies for the JobKeeper scheme and is entitled to receive JobKeeper payments of $1,500 each fortnight for Sam, paid monthly in arrears by the ATO. Sam's practice gives her a JobKeeper enabling stand down direction that reduces her ordinary working hours from 76 to 60 hours per fortnight.
As a GPT1, Sam's base rate of pay is $38.73 per hour, which her employer cannot reduce. But she now only works 60 hours a fortnight and her fortnightly pay has reduced from $2,943.60 ($38.73 per hour multiplied by 76 hours worked in a fortnight) to $2,323.80 ($38.73 per hour multiplied by 60 hours worked in a fortnight).
Sam’s reduced fortnightly pay is still higher than the fortnightly JobKeeper payment of $1,500 (before tax). This means her practice must pay her $2,323.80 per fortnight (before tax), which includes an amount equal to the $1,500 JobKeeper payment (before tax).
Sam's practice has been unable to enable her to undertake telehealth and patient bookings for her are still very low, so that Sam is only seeing 4 or 5 patients a session. Sam’s practice gives her a new JobKeeper enabling stand down direction, which reduces her ordinary working hours from 60 hours to 38 hours per fortnight.
Sam’s employer now must pay her $1,500 per fortnight (before tax), i.e the amount equal to the $1,500 JobKeeper amount, even though this is more than her base rate of pay for 38 hours per fortnight of $1,471.80 ($38.73 per hour multiplied by 38 hours worked in a fortnight).
Do you have any Telehealth supervision resources?
(29 April 2020)Expand
About this template
This is a general template designed to assist GP trainees, who have to perform telehealth consultations, with considering their supervision requirements when they are practicing in this way. (Not all sections may be relevant to you, your practice, your supervisor or your training region; add and remove sections as needed).
Once completed and signed by both GP trainee and supervisor, it is recommended that a copy of this completed template should be given to whomever is responsible for overseeing the GP trainee’s education and training (for example, their medical educator and/or RTO).
Please note: RTOs may have telehealth supervision templates or other guidelines for GP trainees who are undertaking telehealth consultations and/or training and education activities. GP trainees should first check with their RTO and use the appropriate resources, templates and procedures that are required for their training circumstances.
GPRA acknowledges GP Synergy for the use of some of the content in this template.
Do you have any advice or resources for GP trainees working from home during the COVID-19 pandemic?
(29 April 2020)Expand
Yes, please see our advice and resources here.
What does the expansion of MBS Telehealth item numbers mean for GP trainees?
(23 March 2020)Expand
MBS Telehealth item numbers can now be used by GPs or registrars who are in an at risk category.
Any GP trainee who has been concerned about:
- an immunocompromised state,
- being a parent of an infant under 12 months of age
- or having a chronic medical condition that increases their risk of COVID-19
Will now be able to work without face-to-face contact with patients either on-site or off-site depending on what they are comfortable with and their practice set up.
Is there additional flexibility on the AGPT program?
The Department and the Colleges have agreed that registrars training on the AGPT Program will be able to exceed their prescribed training time cap (as specified in clause 5.13 and 5.14 of the AGPT Training Obligations Policy 2019) if their training is affected by the impacts of COVID-19.
Registrars affected by the impacts of COVID-19 will also be able to access other flexibilities of the AGPT Program Policies, including extensions of training time, leave from the AGPT program and deferral of the commencement of training. These flexibilities of the policies for impacted registrars can be approved by RTOs and do not need to come to the Department or the Colleges for approval.
Colleges will be able to consider exceptions from the training location obligations and the ability to transfer between pathways for impacted registrars on a case-by-case basis.
In addition for registrars requiring Category 2 leave from the program due to COVID-19 this will not be counted towards their training time cap and should be granted even if registrars have exceeded the leave and extension allowances specified in the policies.
When will the RACGP exams run in 2020?
(19 March 2020)Expand
The RACGP Board has made the very challenging decision to postpone upcoming RACGP exams in light of the evolving COVID-19 situation. This will not just affect the 2020.1 OSCE but also the 2020.2 AKT / KFP and a run on effect to the 2020.2 OSCE. With the 2020.1 OSCE and 2020.2 AKT / KFP exams all within the next four months and GPs in training under way with their studies and putting their lives on hold as a result, it was decided that an early decision and clarity of a plan for the sitting of these exams was crucial. Below, is a table outlining the proposed dates for the affected exams:
8 November 2020
(Close Of Enrolments tentatively 6 September 2020)
17 & 18 July 2020
(Close Of Enrolments tentatively 15 May 2020)
(Close Of Enrolments tentatively 23 November 2020)
How will COVID-19 affect ACRRM exams?
(17 March 2020)Expand
As the ACRRM training program is designed for digital and distance-based delivery, the College is in a position to enable training and assessment programs to continue with minimal disruption due to COVID-19.
MCQ Online Exam (27 March) will proceed with strong recommendation that registrars participate through distance-based means rather than attending the centralised exam centres. Exam centres will be available with strict social distancing provisions applied.
Primary Curriculum Structured Assessment of Multiple Patient Scenarios (PC StAMPS) (16-17 May) will proceed with strong recommendation that registrars move to video-based rather than exam centre option. Exam centres will be adjusted to provide additional space for social distancing to be applied.
Are there resources on creating a safe workplace?Expand
GP trainees are at high risk as they usually see more “walk-ins”/acute patients and more minor respiratory illnesses than other GPs. Therefore, it is imperative that you regularly revise and seek guidance on:
- Hand hygiene
- Correct PPE usage protocols
- Practice workflows and protocols for managing patients presenting with suspected COVID-19 related symptoms (GPSA has developed some excellent resources to assist practice with this)
Discuss any concerns you may have with your supervisor.
What will happen if I have to self-isolate?Expand
At present, the National Employment Standards in the Fair Work Act allow the same amount of paid personal leave to all employees regardless of whether they are in full or part-time employment.
Therefore, as a registrar employed according to the NTCER, you can access 5 days paid personal leave per six-month training if you are employed on a full-time or part-time basis.
The NTCER (cl 6.3) allows for personal leave to be provided in advance (rather than having to be accrued).
Given the unprecedented circumstances, GPRA encourages training practices employing GP registrars on a 12 month contract to allow for the annual allocation of 10 days paid personal leave to be made available, in advance, should a registrar require this leave for self-isolation.
GPRA is continuing to explore options to enable access to additional paid leave due to COVID-19 related self isolation and/or illness.
Can I make a WorkCover claim?Expand
Enquiries have been received regarding whether a GP trainee in self-isolation or in recovery from COVID-19 related illness could be paid through a WorkCover claim.
At present this is unclear. A key factor that would need to be addressed is being able to definitively demonstrate that the self-isolation and/or illness directly resulted from workplace-related exposure.
If you are diagnosed with COVID-19 and wish to make a workers’ compensation claim, please refer to your state’s WorkCover agency for relevant information.
Can I refuse to see patients with symptoms of COVID-19 or who have travelled from high-risk countries?Expand
MDO advice is that “it is reasonable to refuse to see patients with symptoms of COVID-19 if [your] practice cannot comply with the safety guidelines provided by the Department of Health and RACGP”, e.g. the use of PPE when managing patients with suspected coronavirus in a GP setting, etc. Please discuss this with your supervisor, if you have concerns.
Will the MBS fund telehealth consultations?
(31 March 2020)Expand
As part of the Commonwealth Government’s health package to tackle COVID-19 the new, time-limited Medicare Benefits Schedule (MBS) item numbers for the delivery of bulk billed telephone and video consultations have been expanded as part of the fourth stage of a series of primary care measures.
The most recent update is that these new telehealth (video-conference) and phone consultation items will be available to all Australians, effectively enabling whole of population telehealth for patients, general practice, primary care and other medical services to be available from 30 March 2020 to support the response to COVID-19.
These changes will further assist GP trainees being able to undertake MBS-funded tele-health consultations.
Are registrars able to change pathways in light of these COVID-19?Expand
It is understandable that registrars who would have completed all training requirements, but are blocked from Fellowship due to the postponement of the OSCE may have already started to make plans for life after Fellowship. This may have included a change of living location.
Colleges understand that registrars impacted by the exam postponement may be further disadvantaged in their personal lives by not being able to pursue their plans.
Colleges will be able to consider exceptions from the training location obligations and the ability to transfer between pathways for impacted registrars on a case-by-case basis.
Can registrars perform other telehealth work external to their training if they are forced to self isolate?Expand
With the adoption of MBS Telehealth numbers and the current lobbying to have the restrictions on these item numbers lifted, it is assumed that most registrars will have the ability to not interrupt their training due to self isolation needs as long as they feel comfortable performing Telehealth consultations.
This does require the registrar to be well enough to consult via Telehealth, i.e. if symptoms are mild or if they are self quarantining due to a positive contact, or if they are needing time off due to an immunocompromised state that puts them at increased risk from COVID19.
If a registrar needs to take category 1 leave because alternative options such as off site Telehealth cannot be provided by their practice then RACGP has stated that work whilst on this leave would be approved as long as it is in keeping with the reason for leave. This is consistent with AGPT policy on leave.
What PPE should GP trainees use when caring for persons with suspected or confirmed Coronavirus disease (COVID19)?Expand
The Australian Health Protection Principal Committee (AHPPC) has endorsed interim recommendations for GPs for non-inpatient care of people at risk of or with suspected or confirmed COVID-19, including the use of personal protective equipment (PPE) and this clarifies when to wear surgical vs N95 masks.