How competitive are basic physician training and GP scheme in Oz?

[imgyg]

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[qldking]

Neither are difficult to get into and basic physician training has probably the bleakest future of any field in medicine

 

[imgyg]

Why do you say that about BPT?

 

[qldking]

Why do you say that about BPT?

Because all you do in physician work is paperwork and administrative nonsense

 

[pitman]

That's an odd claim and not consistent with what I've seen in Australia.

Many med dept heads in the (non-tertiary, non-remote) hospitals where I've locumed are basic physicians. Physicians in urban centres are also increasingly working in, or starting, GP-style clinics that involve or are affiliated w/ specialists. Several friends of mine who are in physician training are considering stopping at the basic level of training to do just that. They also believe that current trends and interest suggest this will become very popular in the next decade (at least in regional centres) as an alternative to the currently predominant GP --> external referral system.

 

[imgyg]

That's an odd claim and not consistent with what I've seen in Australia.

Many med dept heads in the (non-tertiary, non-remote) hospitals where I've locumed are basic physicians. Physicians in urban centres are also increasingly working in, or starting, GP-style clinics that involve or are affiliated w/ specialists. Several friends of mine who are in physician training are considering stopping at the basic level of training to do just that. They also believe that current trends and interest suggest this will become very popular in the next decade (at least in regional centres) as an alternative to the currently predominant GP --> external referral system.

You mean they are dropping out of BPT in order to become career medical officers working in clinics with specialists?

 

[qldking]

Wow what a surprise, your 'experience' is yet again completely different from mine/reality.

General Medicine is essentially working with geriatric patients.

I never said the specialties were bad--it's just all they do now is paperwork, which ruins the beauty of the field.

 

[qldking]

You mean they are dropping out of BPT in order to become career medical officers working in clinics with specialists?

I think what hes saying is some people are completing only the three years required to be a general physician and not going into specialty training--thats a load of BS but he exists in world that is vastly different from reality.

 

[pitman]

Do you not understand the logic, qldking? You said that physicians just do paperwork. I respond by saying that that is not the case -- indeed, any anecdote proves you wrong, just as it does with all your silly absolutist claims based on your limited experience. But I know of many exceptions, and I know many physicians, and I have worked at many many hospitals as a locum.

I don't doubt that in your limited experience, you may have only seen them doing paperwork, but to extrapolate that to claim that's all they do is not only irrational, it's self-centred, and sounds to a normal person delusional.

 

[pitman]

You mean they are dropping out of BPT in order to become career medical officers working in clinics with specialists?

No, I mean general med physicians. Sorry for any confusion, I was responding in context of qldking's silly assertions -- that there is no future for 'physicians', by first oddly singling out those who do the BPT path, as though there is no future for those who do basic physician training (um, their future is presumably as a physician), and as he later confirmed, he is in fact not just talking about general med physicians (claiming all they do is paperwork), but even surprising to me, he's talking about and condemns all physician specialists. Sad but true.

 

[pitman]

...

 

[pitman]

General Medicine is essentially working with geriatric patients.

Really? Then why are there so many job adverts for general med physicians to do clinical work other than geriatrics (which is still clinical, mind you, unless you're suggesting geriatrics is all paperwork)? These jobs don't really exist in your world?
http://au.indeed.com/General-Physician-jobs-in-Queensland

 

[imgyg]

So pitman, can you expand on the comment about people dropping out of bpt as i don't really understand why

 

[pitman]

I never said the specialties were bad--it's just all they do now is paperwork, which ruins the beauty of the field.

Crazy stuff. It's amazing how many specialist physician clinics get referred by GPs, to do...paperwork on their patients.

https://healthengine.com.au/find/General_Medicine/Brisbane/

I picked Brisbane because I know some of those listed. Just like for those jobs advertised as per two posts above, they aren't just (or in many cases even predominantly) doing geriatrics.

 

[pitman]

So pitman, can you expand on the comment about people dropping out of bpt as i don't really understand why

Whose comment, qldking's? I was referring to general med physicians, not Basic Training Pathway physicians while still in Basic Training. As said above, apologies for the confusion (for my use of the word 'basic'), but I was responding more generally to qldking's sweeping generalization about (first general, then all) physicians.

I can tell you that people do quit physician training at the BPT level, often because the exams are a bitch. Of those I know who did, most went into GP training. However, this isn't unique to physician training -- I know junior docs who bailed out of many specialist colleges to join GP training, or at least try to (GP training has become somewhat competitive in the past few years..not crazy competitive, but enough that somewhere around 40% of candidates are now getting rejected, at least in Qld, and rejected for what I would consider arbitrary assessment criteria for the so-called "standardized" interviews).

 

[imgyg]

I see. Thanks for your response. But what about general med physicians stopping at the basic level of training in order to run clinics? Is that because of exams?

 

[qldking]

All you need to get onto the training program is for a Director of Clinical Training to sign off for you to pursue the pathway. This can be done after intern year. So it's possible that the exams are a serious screening process since essentially anyone can get onto basic physician training to start.

Then you need three years of general medicine training and need to pass relatively difficult exams (USMLE style exams) and then try to get onto a specialist training program. It's very rare for anyone to willingly want to not pursue specialty training. If you ever do a term in General Medicine, you'll notice that it's about 80% paperwork and referrals, round the clock work, and nonstop red tape. It may be possible that GP clinics are trying to poach general physicians but I don't know of many people who go into the field with that intent.

 

[bashwell]

Just curious, how's it like getting onto ED as a registrar in QLD? I believe currently in NSW it's relatively easy, compared to other specialties. (Although like almost everything else it seems like even ED could get more competitive in future.)

 

[qldking]

I have no clue about ED. I thought everyone was getting out of it because the Nurse Practitioners were taking over the game.

 

[pitman]

Just curious, how's it like getting onto ED as a registrar in QLD? I believe currently in NSW it's relatively easy, compared to other specialties. (Although like almost everything else it seems like even ED could get more competitive in future.)

It's very popular and not terribly difficult in Qld, though I've been told by former school-mates that the exams have been toughened up, and they've made it harder to come back to ED (through not recognizing prior training) after having left it for more than ?a year.

FACEM has increased its training numbers second only to the GP colleges in response to the tsunami. FACEMs may eventually be pushed out rural because of the coming glut, which could affect rural generalists in many of the moderately sized rural hospitals (where there is separate staff for ED and the med ward/O&G). Nurse practitioners are new on the scene and can handle most Cat 3+ (not sure what the actual rule is) including ordering many drugs and doing most procedures you'd see done in an ED's procedure room. Bringing them in doesn't seem to me to be a rational move in light of the glut of junior docs, but that's TBD.

 

[imgyg]

All you need to get onto the training program is for a Director of Clinical Training to sign off for you to pursue the pathway. This can be done after intern year. So it's possible that the exams are a serious screening process since essentially anyone can get onto basic physician training to start.

Then you need three years of general medicine training and need to pass relatively difficult exams (USMLE style exams) and then try to get onto a specialist training program. It's very rare for anyone to willingly want to not pursue specialty training. If you ever do a term in General Medicine, you'll notice that it's about 80% paperwork and referrals, round the clock work, and nonstop red tape. It may be possible that GP clinics are trying to poach general physicians but I don't know of many people who go into the field with that intent.

Thanks for response.

With all due respect, having worked in the irish healthcare system, no amount of redtape and paperwork could compare with what goes on there, so I think no matter how bad it is in Australia, I'm sure it's not comparable

 

[imgyg]

Does anyone know if you need to be a permanent resident or citizen to apply for GP scheme?

 

[bashwell]

Does anyone know if you need to be a permanent resident or citizen to apply for GP scheme?

1) Someone like @pitman would be ideal to answer this.

2) But speaking as a poor man's @pitman, i.e. I may well be wrong, my understanding is no you don't. But I believe you do at least need a (temporary) visa. I think it's called something like a 457 visa if that sounds familiar to you? I've met one or two UK/Irish doctors on a 457 I think it's called. Although I'm not sure if they were already GPs before coming here (via reciprocal agreements or arrangements of some sort) or they got onto and became GPs here.

3) I'm not entirely sure but I suspect it might also help your case if you can at least get onto a GP trainee program in Ireland?

4) Google may help a lot. For example:

http://www.racgp.org.au/becomingagp

 

[pitman]

There are three pathways for vocational training that you can apply to, each of which leads to GP Fellowship in one (or both) of the two GP colleges (there are other training routes that are less straight-forward, but I'll skip those for simplicity): the AGPT (and then joining either or both of the colleges, ACRRM or RACGP), RVTS (again, ACRRM and/or RACGP), or the Independent Pathway of ACRRM. The easiest way to think of these pathways is that they reflect the three different funding models available.

The visa requirements for applying have changed a bit over the past 5 years or so, but currently the former (AGPT) pathway requires that you be a permanent resident or citizen to apply, while the latter two accept temporary residents. The first two are federally funded bureaucracies, while for the Independent Pathway, the trainees pay their own way.

Try these for more info:

http://www.gpet.com.au/Junior-docto...T--program/New-applicants/Application-Process

http://www.rvts.org.au/applicants/eligibility

http://acrrm.org.au/ipapplication-2013

 

[imgyg]

Wow thanks pitman that's great information, I'll read the links now. Much appreciated

 

[johnnyb255]

Neither are difficult to get into and basic physician training has probably the bleakest future of any field in medicine

I'm sorry but I don't think you understand Physicians training in Australia.

In terms of competitiveness, traditionally there was no interview or selection into the program- if your Director of Physicians Education at your training hospital approved you then you were in the program. With the significant increase in junior doctors and not so significant increase in training positions, this is no longer the case and it is now far more competitive in most tertiary hospitals which are accredited for training.

Secondly BPT in itself is simply the years undertaking preparation for the College exams (Part 1 is a two part written exam on basic and clinical sciences, Part 2 is clinical comprising 2 longs and 4 shorts), rotating through General Medicine (Internal Medicine) and the medical specialties as a service registrar (which is a non-training registrar). On passing these exams (eligible to sit in the third year of BPT) you can progress to Advanced Training, which takes 3-4 years and includes all the medical specialties under the Royal Australasian College of Physicians (Cardiology, Gastroenterology, Neurology, Respiratory etc). To reiterate- you can only start training in these specialties after completing BPT and passing both exams.

So to say Basic Physicians Training has a bleak future is to say all medical specialties have a bleak future.

You may be referring to Acute and General Medicine (Internal Medicine), which is one of the Advanced Training streams offered by the College. While for the last two decades it is true- there was a shift away from Gen Med, it has undergone a resurgence with the 'Acute Medical Unit' model of hospital care adopted from the UK, so Gen Med or dual training Gen Med with specialty jobs are now in higher demand. General Physicians are also greatly in demand in outer metropolitan and larger rural hospitals.

 

[qldking]

I know Physician Training well as I have already gone through the process.

The future is bleak because all it is now is paperwork and endless work. I was never commenting about job availability. Almost nobody I know who is currently going through BPT or has finished it is satisfied with his job.

 

[johnnyb255]

I know Physician Training well as I have already gone through the process.

The future is bleak because all it is now is paperwork and endless work. I was never commenting about job availability. Almost nobody I know who is currently going through BPT or has finished it is satisfied with his job.

Of course your friends aren't satisfied with their jobs, they are registrars. They aren't meant to be satisfied with their jobs- it's absolute medical hell working long hours and once the work is done staying in the hospital to see patients for the clinical exam- but they are going through it to become Consultant Physicians in a specialty that they (presumably) want to do for the rest of their working lives.

Once you finish BPT, you apply for Advanced Training. You need to finish Advanced Training to be a consultant, and then you are a boss and you can be satisfied. Yes it is a really hard slog, the exams are up there with the toughest qualifying exams in the world, but Physicians are held in high regard in Australia because of these barriers.

As for paperwork, welcome to the 21st century. It isn't limited to being a med reg.

I'm not sure what you mean by 'gone through the process', but if you have finished Physicians training I'm surprised by your view.

 

[qldking]

'Gone through the process' generally indicates that one has gone through a process referred, e.g. I am a registrar or consultant Physician.

 

[johnnyb255]

'Gone through the process' generally indicates that one has gone through a process referred, e.g. I am a registrar or consultant Physician.

Well since you graduated between 2 and 3 years ago, you aren't yet eligible to sit your exams, meaning you couldn't possibly have 'gone through' (ie completed) BPT, yet alone physicians training in general.

Hence my confusion.