Are we preparing Victorian general practice registrars to be confident in all aspects of primary care paediatrics?

BACKGROUND AND OBJECTIVES: General practitioners provide essential primary care to paediatric patients. The aim of this study was to explore associations between prevocational paediatric experiences of general practice registrars and their confidence in providing paediatric care in the general practice setting. METHOD: This was a cross-sectional observational study. Paediatric experiences and level of confidence ratings were collected using an online survey emailed to 530 Victorian general practice registrars in 2017; the response rate was 41% (217/530). Analysis used descriptive statistics, cross tabulation and Fishers' exact test. RESULTS: The most common paediatric training was undertaken in a general hospital emergency department (180/197, 91%). The majority of registrars reported that they felt confident or very confident in managing acute presentations (92% for upper respiratory tract infection, 80% for asthma, 81% for immunisation), but fewer were confident in managing mental health, behavioural or developmental presentations (all <36%). DISCUSSION: Registrars felt more confident managing acute presentations. However, the predominantly hospital-based prevocational paediatric training offers limited exposure to - and, thus, confidence in - managing behavioural, mental health and developmental issues. Training opportunities to address this identified gap should be explored.

Practice based assessment.

BACKGROUND: Practice based assessment (PBA) was designed to suit the needs of doctors eligible to sit The Royal Australian College of General Practitioners Fellowship (FRACGP) exam via the practice eligible route. A pilot program of the PBA was undertaken in 2000. As a result of recommendations by candidates and examiners and ongoing literature review, a number of changes have been made, but the basic structure of the assessment process remains. OBJECTIVE: This article describes the components of the PBA route to the FRACGP and discuss how candidates can prepare effectively for their assessment. DISCUSSION: The PBA involves five components: an enrolment submission including details of general practice experience curriculum vitae and details of continuing professional development; a professional portfolio including evidence of CPR proficiency, a practice profile and a list of 25 professional peers who have shared the care of patients; videotape of 90 consultations; an examiner clinical visit; and a 20 question viva.