Furthermore, you should receive your base hourly rate of pay, as paid public holiday leave, for this day as per any other employee.

Vocational registration is a part of your College’s fellowship process. This process can take six to 12 weeks to complete following the submission of all your application paperwork.

When the process is complete, you will receive your VR Medicare Provider Number and will be able to work as a GP contractor.

Working in general practice before you receive your VR Medicare Provider Number

To continue working in general practice you will be required to practice in an accredited training facility with your College under an “Extension Awaiting Fellowship”, a once-off extension on your GP training of up to 12 weeks, arranged by your college.

Registrars may seek an extension to their training time within certain limits as per the relevant policies of each college.

If seeking leave from the AGPT program, a deferral or an extension of training time, registrars should contact their college in the first instance.

During this extension you will continue to be employed as a GP registrar and your employment terms and conditions will still be subject to the NTCER.

While on your Extension Awaiting Fellowship is entirely reasonable for you to renegotiate the terms and conditions of your employment during this period to be more aligned with what would be offered for consultant GP.

This is because you will no longer have supervision requirements and adjustments in your share and/or frequency of payment of percentage billings (and/or other terms and conditions).

Renegotiation is also consistent with provisions in the NTCER (section 2), in that the: “registrar and employer may negotiate terms and conditions different from those outlined [in the NTCER] by mutual agreement, provided they are no less favourable to the registrar”.

Alternatives to consider while awaiting your VR Medicare Provider Number

Alternatively, if you do not want to apply for an Extension Awaiting Fellowship, you can undertake medical practice in a setting that does not require access to Medicare (for example, a hospital locum position). You may even choose not to practice at all during this period.

See also: Welcome to becoming (or about to become) a newly-Fellowed General Practitioner!

This is not true. Registrars may be able to lawfully resign from their training placement before the expiration of their fixed-term contract, but it depends on the circumstances.

Registrars may be liable for damages for breach of contract if they resign without an early-termination clause in their employment contracts (or fail to comply with such a clause). Registrars contemplating resigning should review their employment contracts to understand their obligations in respect of termination of their employment.

Registrars may be able to lawfully resign before the end of the term if, for example, they do so in accordance with an early-termination clause, or, their employer agrees to the resignation.

However, there is an expectation that registrars will remain employed for the duration of the term. This is reflected in clause 20 of the NTCER, which provides that a registrar’s employment should not be terminated before the completion of a fixed term, other than in exceptional circumstances (e.g. serious misconduct, or a change in the registrar’s circumstances).

A decision to resign from your employment should not be made lightly and without understanding the potential implications of this for your progression through the training program.

We encourage registrars who are considering resigning from their employment to seek support from their Registrar Liaison Officer, relevant College, GPRA and/or seek independent legal advice.

Registrars may be entitled to be paid for the time they are available to work (i.e., on call), and the hours they’re called to work. A registrar’s right to receive remuneration in these cases will depend on the circumstances of the registrar’s engagement, including in particular, the terms of the registrar’s employment agreement.

As a general rule, you should be paid for all work you perform (including taking phone calls in the course of your duties where this is for your employer’s benefit).

Practices may also pay an allowance to doctors for “being available” on-call (irrespective of whether the doctors perform any work whilst on-call). If other doctors of the practice are paid an “on-call allowance”, then the registrar should also receive payment when they are rostered on-call (NTCER, clause 10.11). You should find out what the on-call policy is in your practice.

Even if other doctors in your practice are not paid an “on-call allowance”, you may still be entitled to be paid for the time you are on-call in certain circumstances, particularly if you are required to remain at your workplace. You should seek advice from GPRA or independent legal advice about this.

GP registrars employed as per the NTCER should not have GST deducted from their Medicare billing payments or salary.

There are a small number of placements that do not fall under the jurisdiction of the NTCER (if you are in such a placement and GST is being deducted from your payments it is recommended that you seek advice from an accountant). However, for the majority of registrars, where employment is in a private community general practice, a GP registrar’s employment will be subject to the minimum terms and conditions set out in the NTCER.

The reason for this misunderstanding is that fellowed GPs who are sole trader contractors pay their practice a ‘facility fee’, which attracts GST (which the sole trader contractor GP then claims back through their quarterly BAS).

According to the NTCER, GP registrars are considered to be employees (not sole trader contractors) and should be paid at a base hourly rate and then a “bonus” amount is paid if the percentage of billings exceeds the amount already been paid at the base rate.

As Medicare Benefits Scheme payments are GST free, GST should not be deducted from MBS billings when calculating the bonus.

This is described in NTCER Clause 6.3 states:

“Registrars are entitled to an advance of 38 hours paid personal/carer’s leave for each 6 month period of employment upon commencement of the term, pro-rata.”

In contrast, annual leave generally has to be accrued before it can be taken; however, due to the nature of general practice training, registrars can request access to annual leave that has not yet been accrued, by negotiation with their practice (as per NTCER cl. 6.1).

It is important to note that in the event that a registrar has taken unaccrued personal leave and/or annual leave and terminates his/her employment, then the employer is entitled to withhold an amount equivalent to those hours taken (NTCER cl. 6.2 & 6.3) in determining termination payments.

Firstly, according to the NTCER clause 10.1: Full-time employment is employment based on a 38 hour week averaged over four weeks. But remember, this 38 hours includes not only patient consultation time, but other activities during ordinary hours, as per NTCER clause 10.6:

a) normal general practice activities such as:

• Scheduled consulting time (whether seeing patients or not)
• Home, hospital and nursing home visits including travel time
• Administrative time (e.g. writing notes, telephone calls, reports);

b) practice-based teaching time; and
c) educational release time.

As per NTCER clause 9.2, as a guide, educational release time could be allocated from 0-3.5 hours (depending of stage of training and RTO requirements), and in practice teaching from 0-3 hours each week (again, depending of stage of training and College requirements). Administration time should be approximately 2.5 hours a week (for full-time), which usually equates to 15 minutes per consultation session.

So these activities are included in your ordinary and paid time.

Having said that, if you are not working full-time (i.e. 38 hours per week) the NTCER does allow for your base salary (and leave entitlements) to be pro-rated. The relevant clauses of the NTCER are as follows:

0.2 Part time
Part-time employment is any number of hours less than 38 hours/week averaged over a 4-week cycle. Rates of pay and leave for part-time employees are pro-rata based on a 38 hour week.

11 Remuneration
The rates of pay for registrars are set out in schedule A of this agreement. The full-time base rate of pay is based on a full-time, 38 hour week. The part-time base rate of pay shall be calculated on a pro rata basis.
As such, it is possible to meet the requirements of full-time training (e.g. 27 hours of patient consulting time for RACGP) but be employed on a part-time basis.

Check your College policies or registrar handbook first.

Weekend work is considered to be a normal part of general practice and Saturday morning (8am – 1pm) is actually within the ordinary span of hours (as per NTCER cl. 10.5). So, if weekend work for the registrar is within the 38 hrs full-time, or part-time pro-rated, load (or has been mutually agreed as additional hours or overtime) and other GPs in the practice are also working to a similar roster, then this is allowed under NTCER provided that there are appropriate arrangements in place for supervision.

In fact, there is no clause within the NTCER that explicitly excludes registrars from being rostered to work every weekend.

While noting that after-hours work is “considered to be a normal part of general practice” (NTCER cl. 10.10), it is important to recognise that for after-hours work (i.e. outside the ordinary span of hours of between 8am and 8pm Monday to Friday and 8am and 1pm on Saturday), the clear expectation is that rostering arrangements for registrars “shall be no more onerous than those of other full-time doctors in the practice (pro rata for part-time registrars)” (as per NTCER cl. 10.10).

The specific intention is to prevent registrars being overused for, or carrying a disproportionate load of, the weekend and after-hours rostering. As such, there should be other GPs who are also rostered to work weekends at the practice on similar schedules to the registrar(s).

To avoid any confusion or disagreement down the track, it is always best to discuss the weekend rostering arrangements with the practice prior to commencement (i.e. at the interview) and have this included as part of the employment agreement.

GPRA strongly recommends having a signed employment agreement before starting work.

Having all aspects of your employment arrangements (for example, leave, education release and in-practice teaching provisions; rostering; on-call, after-hours and home-visits requirements, etc) in writing is in the best interests of both you and your employer — it protects both parties, ensures you are on the same page, and provides clarity if there is ever a dispute about the terms and conditions of your employment. GPRA provides an employment agreement template that can assist.

It is also very important that you read and ensure that you understand ALL clauses and items in the employment agreement, BEFORE you sign off, as this is a legally binding contract. If you are uncertain about any item, discuss and clarify this with the practice manager or supervisor. Do not make assumptions or gloss over things!

Even if the terms and conditions of your employment are the NTCER minimum, be sure to have this in writing. Read the NTCER document when you are reviewing the employment agreement so that you know what these minimum terms and conditions are, before you sign.

Remember, a signed employment agreement also gives you the opportunity to put any special items in writing, such as specific dates of annual leave or rostering arrangements (This may be important for you, if you have specific family needs or other commitments). It also gives you the chance to negotiate your terms and conditions above the NTCER minimum.

A helpful tip is to request a mid-term review of your employment agreement and include this in the written agreement. This allows for the possibility of renegotiating some of your terms and conditions and the practice may be more willing to consider this once you are better known and have demonstrated the value you bring to the practice. But be sure to get everything that is agreed upon included in your employment agreement and signed off by both parties.

Starting to work without a written employment agreement does not mean that a contract does not exist. Essentially every employment relationship involves a “contract” between an employer and an employee.

This contract may be verbal or in writing or may sometimes involve a mix of the two. It is not necessary to specifically agree on a contract for one to exist. If you agreed to start working (even though you do not have a written employment agreement) then this implies some form of “contract” is in place between you and the training practice.

The fact that an employee is working for an employer brings with it certain fundamental implied terms such as the right to payment for work performed.

The inherent difficulty with verbal contracts or relying on implied terms (in cases where there is no specific written agreement or only a limited verbal agreement) is that there can be later disagreement about what was agreed in the first place. And this often comes down to one person’s word against another.

The NTCER sets out the minimum terms and conditions of employment which GP registrars must receive.

Accreditation standards for all AGPT training practices require that the terms and conditions in registrar employment agreements must be no less favourable than the NTCER.

Registrars are free to negotiate terms and conditions above those set out in the NTCER.

GPRA encourages all GP registrars to take an active role and a realistic approach to negotiating their employment agreement.

Once you have Fellowed, as a consultant GP, you will likely need to negotiate for work in general practice as a contractor or employee. Being actively involved in negotiating your employment agreement and understanding the “business-side” of general practice as a GP registrar is a good experience for the future.

Accreditation standards for all AGPT training practices require that the terms and conditions in registrar employment agreements must NOT be less than the NTCER minimum — this means that registrars can negotiate for terms and conditions HIGHER than those set out in the NTCER.

The NTCER is not a Modern Award or an Enterprise Agreement. Your signed employment agreement is the legal document under which you are employed and it should incorporate the NTCER minimum terms. Additionally, as an employee your employer is required to observe relevant State and Commonwealth legislative requirements, irrespective of the content of the NTCER and/or your individual contract.

When negotiating for terms and conditions that are greater than the NTCER minimums which have been negotiated, registrars should consider the value they bring to the employing training practice. Registrars should consider the perspective of the training practice in any negotiation.

Remember, whatever terms and conditions you and your practice agree upon — whether it is the NTCER minimum or above — get it written into your employment agreement and signed BEFORE you commence working for the training practice. This sets clear expectations for you and your employing practice.