Abstract
In many parts of Australia where there is no access to local specialist services, procedural services are provided by local GPs. Within the range of procedural skills offered, a small group of GPs is able to provide surgery. Unlike other procedural areas, there remains no defined training or assessment pathway for GP surgeons. Support from specialist colleagues is variable and continuing education arbitrary. The result is a somewhat ill-defined group that is poorly understood by credentialing bodies, government, medical defence organisations and training colleges. This study aims to describe the scope of practice, initial training and ongoing support and education for GP surgeons currently practising in South Australia. Seventeen semistructured interviews were undertaken with self-identified GP surgeons (74% response rate). Areas explored included demographics, scope of practice, initial training and ongoing support and education. Content and thematic analysis was used to identify common responses and themes. The amount of initial training varied among participants, with a mean duration of training of 20 months. Initial assessment of competency for the majority of participants was assessment by a supervisor (10/17). The most common procedures undertaken were caesarean sections (94% of participants) and grafts and flaps (94%). The most common continuing professional development was clinical attachments (27%) and assisting visiting specialists or colleagues (17%). This study demonstrates a wide variation in training, scope of practice and continuing education for GPs performing surgery, highlighting the effects of a self-regulated system. There is a trend towards an increased level of training; however, engagement in continuing education remains low. Further work is needed to define this group, to enable successful planning of future training and education to support this group in rural areas.
Highlights
In many parts of Australia where there is no access to local specialist services, procedural services are provided by local GPs
Two important issues must be explored to plan for recruitment, training and support of rural GP surgeons: (1) the current scope of practice of GP surgeons, and (2) initial and ongoing training and support
To address these two important issues, this study aims to describe the scope of practice, initial training and ongoing support and education for GP surgeons currently practising in South Australia (SA)
Summary
In many parts of Australia where there is no access to local specialist services, procedural services are provided by local GPs. This study aims to describe the scope of practice, initial training and ongoing support and education for GP surgeons currently practising in South Australia. Scope of practice, initial training and ongoing support and education. Federal and state authorities have attempted to address this deficiency by funding specialist outreach through fly-in/fly-out services These programs do not address emergency procedural services (eg caesarean section, appendectomy), which are often met by the resident GP1-3. Medical colleges have attempted to address the shortage by the introduction of rural training pathways, but these programs have not delivered an increase in rural specialists, or procedurally trained GPs. Two important issues must be explored to plan for recruitment, training and support of rural GP surgeons: (1) the current scope of practice of GP surgeons, and (2) initial and ongoing training and support.
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