Policy: Registrar Withdrawal from Training Policy Section: Registrar Administration Related documents: Commonwealth Department of Health’s ‘Withdrawal Policy 2015’; NCGPT’s Registrar Professional Behaviour Policy; NCGPT’s Registrar & Supervisor Complaints Management Policy; NCGPT’s Completion of Summation Assessments and Extension of Training Time Policy; NCGPT’s Registrar Focused Intervention/Remediation Policy; Department of Health’s Leave Policy; Department of Health’s AGPT Appeals Policy 1. Policy Statement To ensure that NCGPT’s decision making in relation to the withdrawal of registrars enrolled with NCGPT is fair, defensible and consistent with the Department of Health’s Policy on withdrawal of registrars from the Australian General Practice Training (AGPT) program. This Policy applies to all registrars enrolled in NCGPT’s AGPT program and/or any other of NCGPT’s training programs. Registrars will be at risk of being withdrawn from the AGPT program if they are unable, or fail, to meet their responsibilities under this Policy. 2. Program Responsibilities: NCGPT is responsible for: monitoring the health and well-being of registrars enrolled in the AGPT program; monitoring registrar training progress; managing registrar training as required by the AGPT program; ensuring registrars are supported in their training and are able to practice safely; protecting the integrity of the AGPT program; and complying with the terms of this Policy. Registrars are responsible for: monitoring their health and well-being and disclosing relevant information to NCGPT; monitoring their training progress; meeting their training obligations and requirements; acting professionally and behaving responsibly within the training post setting; practising safely; maintaining general registration with reference to ‘recency of practice’ and ‘continuing professional development registration standards’ in accordance with Australian Health Practitioner Regulation Agency (AHPRA) requirements; and complying with the terms of this Policy. 3. Reasons for Withdrawal In terms of this Policy, the withdrawal of a registrar from the AGPT program may fall into one or more of the following categories: 3.1 Category 1 – Voluntary This applies when a registrar advises NCGPT in writing that he/she is voluntarily withdrawing from the AGPT program. Withdrawals under this category shall come into effect after the expiration of thirty (30) days. 3.2 Category 2 – Competence This applies when there are concerns the registrar is unable to sustain an acceptable level of performance to progress with their training within reasonable time and available resources. A registrar who is assessed to be performing below the expected level for their stage of training will usually be assisted by a Focused Intervention and/or a Remediation Plan if necessary. Please refer to NCGPT’s Registrar Focused Intervention/Remediation Policy. Reasons for withdrawal in this category may include, but are not limited to: the registrar refuses to engage in either the Focussed Intervention or the Remediation Plan; the remediation is unsuccessful (or there are no resources available to support remediation, including a suitable general practice placement); the registrar has a “notifiable condition” (notifiable to AHPRA) and is deemed unsafe to continue practising as a GP registrar by AHPRA. the registrar is unable to comply with NCGPT’s Registrar Professional Behaviour Policy. 3.3 Category 3 – Compliance and/or Professional Misconduct This applies when a registrar fails or refuses to comply with the training requirements of NCGPT and/or the AGPT program and/or where a registrar is found to have behaved in a way that constitutes professional misconduct. Each non-compliance and/or professional misconduct situation will be dealt with on a caseby-case basis. Some breaches may result in a warning, while the most serious breaches could result in suspension and/or action to withdraw a registrar from NCGPT’s training program/s. This includes, but is not limited to the following: failure to comply with NCGPT’s Registrar Professional Behaviour Policy; failure to comply with the roles and responsibilities of registrars as set out in the Registrar Handbook; irreconcilable differences between a registrar and NCGPT following failure to reach a satisfactory resolution pursuant to the Registrar and Supervisor Complaints Management Policy; and/or unwillingness to comply with NCGPT’s Registrar Focussed Intervention/Remediation Policy. 3.4 Category 4 – Capacity This applies when a registrar is willing, but for reasons other than listed above, is unable to continue their training. This includes, but is not limited to: if the registrar does not have the capacity to continue in the program due to their particular circumstances (for example, moving overseas, long term medical incapacity, restrictions applying to their registration or unwillingness to practise clinically within NCGPT’s region); if a registrar is non-compliant with the Department of Health’s Leave Policy; the conditions or restrictions on a registrar result in the registrar being difficult to place in NCGPT’s region; if a registrar is persistently unable to be placed in a teaching practice in NCGPT’s region; if a registrar has not practised medicine for more than two (2) years (for example, due to a period of leave) and is unable to demonstrate that they have taken/or taking active steps to remain skilled, even if on leave from the program/s; the registrar has a “notifiable condition” (notifiable to AHPRA) and is deemed unsafe to continue practising as a GP registrar by AHPRA. if there are irreconcilable differences between a registrar and NCGPT following a failure to reach a satisfactory resolution pursuant to the Registrar and Supervisor Complaints Management Policy. In the event of a discrepancy between the scope of the reasons for withdrawal as stated in this Policy and the scope of the reasons for withdrawal as stated in the Department of Health’s Withdrawal Policy, this Policy will take precedence. 4. Procedure for Withdrawal from Program/s In the process of withdrawing a registrar from the NCGPT training program, NCGPT will: observe the rules of natural justice; comply with all legislative requirements, including anti-discrimination and privacy legislation; ensure the registrar is fully informed of the reasons for the proposed withdrawal; ensure the registrar is given an opportunity to assess the evidence and present his/ her case; and 5. ensure the registrar is offered access to a support person (other than a legal representative) throughout the appeals process. Identification of a Registrar Requiring Withdrawal from the Training Program NCGPT maintains a rigorous process of monitoring and assessment of its registrars. The following processes may be adopted in conjunction with any other monitoring and assessment processes outlined in NCGPT’s Registrar Focused Intervention/Remediation Policy and Registrar Professional Behaviour Policy. Processes for monitoring the health and well-being of the registrar may include, but are not limited to: Supervisor and Practice Manager feedback; Formative Assessment Clinical Teaching (FACT) visits; Training advisor contact meetings; Contacts with the Registrar Support Officer; Contacts with Registrar Liaison Officers Discussions held at Supervisor meetings; Observation at education workshops; The opportunity for feedback and debriefing at workshops; and/or Competency reports/ medical certificates from an appropriate health professional. Processes for monitoring training progress may include, but are not limited to: FACT visits; Registrar In-Practice assessments; Video recording of consultations; Clinical supervision and teaching time; Supervisor and Practice Manager assessments and participation at education workshops; Competency reports/ medical certificates from an appropriate health professional; and Implementation of a Focused Intervention or Remedial Plan. Processes for monitoring lack of compliance or professional misconduct may include, but are not limited to: 6. discussions or assessments by NCGPT’s appropriate representatives which may result in a warning or remedial actions; a formal internal or external investigation conducted by either NCGPT’s CEO, the DoT, a Review Committee appointed by the CEO or by an external consultant. Notification to the Registrar If a basis for recommending the withdrawal of a registrar from the training program is identified and substantiated, NCGPT’s DoT and/or CEO will provide the registrar with reasonable notice (at least 24 hours) to attend a meeting to: inform him/her of the reasons for the proposed withdrawal; provide the registrar an opportunity to assess the evidence and to present his/her case with a support person present (who cannot be a legal representative); and 7. explore possible solutions with the registrar including, but not limited to, additional educational assistance, remediation and/or various types of leave as appropriate to the situation (provided it is considered that the performance issues are remediable and do not constitute grounds for immediate withdrawal from the training program). Decision to Withdraw If NCGPT decides to withdraw a registrar from the AGPT program, the registrar will be notified in writing of the reasons for the withdrawal and advised of the appeal process available to him/her. Documentation of all meetings and communication in relation to the withdrawal process will be kept on the registrar’s file. When a registrar receives notice of withdrawal from the NCGPT training program/s, he/she will also be informed that the Department of Health will be notified of the withdrawal. If a registrar is withdrawn under this Policy the registrar is deemed to have been withdrawn from the AGPT program. 8. Appeal of Decision to Withdraw A registrar who is notified of withdrawal from the AGPT program may appeal this decision initially by writing to the CEO of NCGPT. This appeal must detail the grounds of the appeal and evidence to support this appeal. The CEO or his delegate will respond to this appeal within twenty-eight (28) days of receiving an appeal in writing. If the CEO confirms the decision to withdraw the registrar, the Department of Health will be notified and the registrar may then appeal to the Department of Health using the AGPT appeals process as documented in the AGPT Appeals Policy 2015. V:25032015
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