CCCGPT Newsletter | December 2014


Message from the Acting CEO
Supervisor Liaison Officer News
Registrar Liaison Officer News
Gulgala Creation Tour – A Personal Reflection
Jemima Grant
It Department Update
Medical Education Wrap up

Message from the Acting CEO

Dr Tess van Duuren

This is the final newsletter for 2014 – a year of change. We were hoping to have an update on a range of issues, but as we wind down for the Christmas break there is still a lot of uncertainty and little by way of clarification. The announcement of the new training providers boundaries has been delayed, providing ample room for ongoing speculation. The two Colleges, RACGP and ACRRM, have given broad outlines of their training intentions but the proposal is still being considered at ministerial level.

The long-awaited National Terms and Conditions document was released on 15 December 2014 after a number of delays. The document is available on the CCCGPT website for all to access. The Supervisor and Registrar Liaison Officers are aware of the changes within the document, and are available to discuss any issues arising from this – as are CCCGPT staff.

We are now in the process of saying farewell to our most recent Fellows as they complete their training and plan for their futures within the broader general practice community. We are also gearing up to welcome a large new intake of Registrars to our Coast City Country community. Some will continue to work in hospital posts, others undertake extended skills training, and a large cohort will transition to the exciting new world that is general practice in Australia. The CCCGPT staff are working hard to wrap up the year and plan for the new one.

In the absence of both useful updates and our on-holiday CEO, I would like to take this opportunity to thank all the hard-working CCCGPT staff. This year has been tough with change on many fronts to contend with. The staff have risen to that challenge with determination and a single-minded focus on achieving the best outcomes for our Registrar cohort and all who support them. I would also personally like to thank every Medical Educator, Liaison Officer, Supervisor and Practice Manager who has worked so hard to achieve some wonderful outcomes for CCCGPT

Whether working at the coal-face to continue to provide a service while others rest, or taking some well-deserved down time, may the Festive season be one of peace for all. Our best wishes for 2015 and all that it holds.

Supervisor Liaison Officer News Illawarra/Shoalhaven

SLOs are still able to offer support to supervisors on hosting new supervisors and new practices in ways to support employment and education of our registrars – for example by a practice visit. I would invite supervisors in the region to contact me if you wish to book a visit. We are also able to give some advice on Minimum Terms and Conditions, although we would advise seeking legal advice to confirm arrangements if they are unclear. Negotiations for the new 2015 Minimum Terms and Conditions continue and GPSA are having input into this process – it appears that it is likely that Term 3 and 4 registrars may be required to be employees, but GPSA has been actively campaigning for reasonable pay rates for registrars. I am now a board member of GPSA and hope to keep supervisors updated on this process. GPSA are currently advising to delay signing contracts if possible until further information about Minimum Terms and Conditions are available.

The new application process for registrars applying to new practices appears to be working well; we welcome any feedback on this.

Regional training providers are in the process of having to tender to provide training programs. The SLOs will continue to keep abreast of the process of tender , particularly considering issues for supervisors in the transition to new RTPs.

Supervisors in the region should feel free to contact me on my email address [email protected]

The first waves of graduates from the newer medical school are now entering specialist training programs such as the RACGP training program, which has meant an influx of new trainees and increased pressure on GPR Supervisors. Practices are often also hosting medical students and/ or PGPPP trainees and so Supervisors are reporting that already they feel like there are more demands on their time. Of course in regional and rural areas, most GPs will look forward to an increase in the workforce. We hope in the long term they too will become supervisors!

My role as Supervisor Liaison Officer (apart from being a GP myself, and an occasional Medical Educator) is to liaise between GP Supervisors and CCC. Supervisors continue to raise concerns about minimum terms and conditions for registrars, and about other options for employment. CCC has explored the employment of registrars directly by the RTP and found this was not a viable option. I continue to keep abreast of issues discussed by members of the National GP Supervisors Association.

Supervisors also took part in a weekend forum to discuss the new RACGP and how CCC can implement these changes, including for example by streamlining reporting back to CCC via OTACS.
As Supervisor Liaison Officer, I am now able to mentor new supervisors, should they require support, and even do practice visits to discuss ways to facilitate having registrars in your practice. I have enjoyed meeting supervisors this year and look forward to hearing of your concerns into 2014.

Dr Rowena Ivers

Registrar Liaison Officer News

Firstly a big congratulations to all registrars who recently sat RACGP and ACRRM exams. This term saw many of our dedicated registrars working very hard in various study groups to get through one of the most challenging aspects of general practice training. We wish each and every one of them success with their results and upcoming progression and completion of training. I also invite any registrars who are planning to sit exams in the near future, to contact one of the registrar liaison officers for more information regarding CCC exam resources and study preparation workshops, as well as assistance with finding a study group.

Coast City Country is currently working hard to further improve on the already strong exam preparation program and I am sure our 2015 registrar exam candidates will be delighted with the upcoming face to face workshops, webinars, exam question banks and simulated exam practice tutorials. Our RTP is gaining a lot of exam prep momentum with the goal of seeing each and every registrar get through this hurdle, whilst gaining excellent training and professional development.

During the month of November, the General Practice Registrars Association held a nationwide RLO teleconference which I was able to attend on behalf of all of the other CCC RLOs. I would like to reassure our registrars that GPRA will work very hard at advocating on behalf of all trainees during these uncertain times in general practice training. The most current and updated version of the National Minimum Terms and Conditions document is also due for release in the coming months and will outline the aspects of work conditions that registrars and practices should consider prior to signing up a work contract. This document is very important and I urge all registrars to read it prior to meeting with future practice supervisors and managers. Other issues discussed at this meeting included issues surrounding the handover of the role GPET to the Department of Health and the importance of a registrar’s training progress being honoured by all parties bidding for a tender for GP training in 2015. In the coming months you will see more policies and position statements being released by GPRA regarding the future of our training and how to safeguard high standards of teaching. It is at this turning point that I urge our registrars to become more vocal in regards to issues that matter most to quality training and to get involved with GPRA advocacy activities.

Finally, for the 2015.1 term, CCC rolled out a new method of registrar placement which saw our registrars personally applying to, and attending interviews with preferred group practices. Feedback so far has found that this method has worked well for the majority of registrars but for those who faced difficulties and road blocks, please be assured that formal feedback processes are taking place, and your RLOs are determined in making sure such problems are ironed out for future placement applications by passing on your concerns to directors of training. Please feel free to contact your LTG RLO if you have concerns or feedback regarding any aspect of training.

Dr Shab Cook


Gulgala Creation Tour 24-26 Oct 2014

A Personal Reflection – John Padgett

I had the opportunity with my wife, Sally, to participate in this Aboriginal culture immersion experience, held at Narooma on the NSW South Coast.

The Yuin people are the traditional custodians of this country. We were welcomed on the Friday evening by Dwayne, the eldest grandson of Uncle Max Dulumunmun Harrison (who began doing these tours 40+ years ago, in order to share with non-indigenous people the stories of the land and the connection that local Aboriginal people have with it). We experienced the “cleansing” smoking ceremony of welcome and then were treated to some traditional dance on the beach – the black duck dance (the black duck is the totem of the Yuin), a snake dance, and a dance depicting traditional spear fishing.

After dinner, we sat in a “yarning circle” to share why we were there. There were 14 of us in the group, along with Dwayne, his wife Amelia and their two children – Kayen and Laycee – and, Sameeka (our chief cook) and Makeya (hostel manager and co-guide for the tour). Our group consisted of two families and two couples, from diverse backgrounds.

We were all up at 6.15am the next morning for the welcome ceremony for “Grandfather Sun”, to greet the new day. Part of this was wearing a piece of red wool around our head to indicate that we were participating in “ceremony”. (When “in ceremony” – there is no eating, no drinking, no smoking, no alcohol). The Sun is one of the elements influencing people’s lives. The other elements are “Grandmother Moon”, “Mother Earth”, the saltwater “mob” – the ocean; and, the “freshwater mob” – the inland water courses and rain.

Following breakfast, we drove in “snake” convoy to the hamlets of Central Tilba and Tilba Tilba (“Tilba” means windy). Along the way, Makeya pointed out an area on the hills which was the traditional birthing place for the Yuin. From our vantage point we could see the bulge of one hill which symbolises a pregnant woman’s abdomen, which has a rocky outcrop on it reminiscent of a placenta. At the same place we could see Gulaga Mountain, Najanuka(Mt Little Dromedary), behind which (off the coast) is Baranguba (named by white people, Montague Is). The story of Gulaga giving birth to Baranguba and Najanuka and how Baranguba ended out in the sea was fun to learn about.

From Pat’s Store at Tilba Tilba, we walked through farmland, up the the edge of Gulaga National Park. In 2006, this park was handed back to the traditional owners, and is currently managed by the National Parks and Wildlife Service of NSW. From the entrance to the park, we walked separately and in silence as a mark of respect to Gulaga, until we reached the picnic area near the top.

After lunch, we participated in the sweeping ceremony. As part of this, we all had facial mud paint applied – “to open our minds, to keep our eyes seeing and to pay respect to the elders”. We were then lead into the area of the sacred rocks – you would only know they were there if you were told. They are not signposted at all. Before we entered this area, Dwayne “knocked on the door” using his wooden rhythm sticks, to announce our presence.
There are seven “chapters” in this creation tour. At each point, Dwayne told stories around the subject:

  • Creation rock with nearby two rocks symbolising woman and man
  • Pregnant woman and midwife – again emphasising the strong idea of fertility in the process of creation
  • Past, Present and Future rocks – Dwayne told us that it is important for people to dwell in the moment (ie. the present), rather than wallow in the past or worry about the future. He told us that the Dalai Lama had a visit to these rocks and at this point spent 3 hours in meditation.
  • Noah’s ark – When the first white missionaries in the area were recounting the Biblical stories, the Yuin people recognised the description and pictures of Noah’s ark. They were thinking, “Yes, we’ve got one of those up on Gulaga mountain”. Dwayne pointed out this “Noah’s ark” rock behind where we were sitting, uncannily in the shape of a traditional ark and balanced precariously on other rocks. Dwayne’s observation was that the creator knew that the white people would come, so gave the Yuin a “Noah’s ark” of their own.
  • Mother with child on hip rock – again the importance of pro-creation and child rearing in the cycle of life.
  • “Highschool” – the teaching/learning rock – high up above the bush floor, a place where the ancient stories were explained and passed on to younger generations.
  • The place where “Uncle Max” asked for permission to arrange these creation tours, which also marked the boundary between common space and women’s place (where we didn’t go).
  • After taking us through these chapters, we retraced our steps and then walked back down the mountain, again in silence.

    Refreshments at Pat’s store, before heading back to our camping ground. BBQ that night with a variety of meats including kangaroo steaks and sausages! Around the fire, we had another yarning circle, where each of us shared our reflections of the day.

    Sunday morning began with a walk along the beach to the inlet just south of us, and we then did the “whale ceremony”, where we called up the whale and asked for safe passage for the whales as they moved up and down the coast. We weren’t fortunate enough to actually see any whales (altho’ previous groups have).

    Back to our accommodation for a delicious cooked brunch, in a relaxed atmosphere. Then warm farewells and the knowledge that we had participated in something special over the weekend. For me, it was summed up in two words: “walking together”. Australia in the 21st century has black history, white history and now multicultural history. In order to understand each other and look forward to the future, it is important to gain knowledge about Australia’s first peoples.

    Dr John Padgett

    Jemima Grant

    Hi All!
    My name is Jemima and my story with Coast City Country goes the full circle!

    I started as a GP Registrar in 2008 with CCCTGP and they can’t get rid of me. At CCCTGP I help coordinate the Prevocational General Practice Placement programme (PGPPP, soon to R.I.P.) as well as contribute to exam resources and Indigenous Health Medical Education. I work as a GP 2 days a week in Bulli which is a lovely coastal community just South of Sydney. My “non work “ time is spent wrangling my 3 gremlin boys and my husband- they are trying to teach me to surf, and I am trying to teach them yoga. It is a constant battle and to tell you the truth I work for relaxation!

    My tip for stress relief is to do a handstand for 1 minute between patients, it really helps to clear your head!

    IT Department Update

    CoastCityCountry’s Public Website now has a ‘Resources’ section, which includes many items of interest for Registrars, Supervisors, Medical Educators, and Practice Managers. These include:

  • Leave Forms
  • RPL Checklists
  • GPET forms
  • The Medical Education Handbook
  • A Resource Kit for Practice Nurses who Teach
  • Our Publications Order Form
  • And many others…

    The website also has search functionality to make finding these resources easier:

    To make our website more user friendly, the Help Page has been divided into sections to reduce confusion and clutter.

    Medical Education wrap up


    As we start to plan for the festive and holiday season the Medical Education team are hard at work planning for the program for 2015.

    While not decking the halls with boughs of holly we are instead ringing some changes in the way that we schedule our out-of-practice teaching. We will be adding an updated calendar to our website soon to ensure that everyone can be aware of key dates.

    In 2015 there will be fewer day release days, which will be offset by the inclusion of three, half-day tutorials each term.

    The term starts off with a three-day orientation, the aim of which is to commence the transition to General Practice. Orientation also includes some assessment of competencies and the outcomes of some key areas will be uploaded to each Registrar’s portfolio.

    Building on the orientation we have programmed three, 2-day workshops in each local training group per term. In addition to this there are three, half-day tutorials or small group learning events facilitated by a Medical Educator and occurring in geographic clusters. All of this is mandatory for the Registrar and takes place in paid work time. Our senior Registrars in GP term 3 and beyond are welcome to attend the small group learning but this is not paid time for them

    We look forward to working with the Coast City Country community next year. Our best wishes for a restful holiday season to everyone.