Our Chair's message to supervision teams on World Family Doctor Day - "We are here for you!”
Dr Srishti Dutta joined the GPSA Board in 2022, eager to contribute her energy and passion to an organisation she respected.
Like a great many of GPSA's members and the registrars they support across Australia, Srishti completed her medical degree and GP training overseas. As Chair of the GPSA Board, she represents the emerging majority of GP supervisors, not only as an International Medical Graduate but as a fellowed GP with a diverse portfolio of healthcare and governance roles, and one who enthusiastically supervises learners across the educational spectrum without wearing the traditional supervisor hat of practice owner / principal.
GPSA's Communication Manager, Pauline Ingham, spoke to Srishti ahead of this year's World Family Doctor Day.
You are a GP with fellowship both here and in the UK, you're a GP supervisor, an ECT visitor, an Examiner for the RACGP, a Medical Facilitator for the Black Dog Institute, and a GP Liaison Officer (GPLO) as part of the joint initiative between Metro North HHS and Brisbane North PHN. How did you come to add Chair of GPSA to this impressive resume?
“I'm the kind of person who doesn't have a specific five- or ten-year plan, but I do have a general sense of direction for where I'm headed. I would say I've had a meandering journey... It's not always a straight path.
"As for how I ended up chairing this well-respected national peak, there were a number of touchpoints and influences.
"One was the supervisor/registrar relationship, and structural issues such as employment contracts that can have a significant impact on the quality of placement experiences. GPSA plays a key role in negotiating the National Terms and Conditions for Employing Registrars (NTCER) and I wanted to lend my unique lens to that process.
"I was fortunate enough to have had a very positive experience as a registrar, with a supervisor who was committed to my growth as an independent GP. I recognised that the relationship between a supervisor and registrar was really quite key to the outcomes of that training experience, underpinned as it was by positive framing and mutual trust.
"This came to the fore when I participated in a GPSA research study exploring the supervisor's role in providing pastoral care in general practice. By engaging with GPSA through a really fun one-on-one interview process, I was genuinely attracted to this organisation's focus on supporting peers and near-peers with compassion, generosity and respect.
"And I've always been struck by the quality and relevance of GPSA's webinars and educational resources - keeping in mind that I had completed my medical training in the UK, and was looking for reassurance that my knowledge and skills translated into competency as a supervisor for Australian GPs-in-training.
"I was certainly inspired to apply for a Director role in 2022 because of the leadership shown by the previous GSPA Board, in particular Drs Nicole Higgins and Madhu Tamilarasan. I recall seeing communications about the outcomes they were achieving and my impression was of a Board that was having fun doing what they were passionate about, so how could I not be tempted to join them?! I just felt that our values were aligned. It seemed like a natural progression for me to take my energy to this place."
How have your various roles prepared you for your work with GPSA?
“It's an interesting question. The key component of directorship is knowledge regarding governance, which I'd developed while working in groups and on committees in the UK, learning how processes worked and what it takes to influence change and systemic improvements.
My knowledge continues to develop and definitely, from a governance and advocacy perspective, there's always more to learn. I'm very much a systems thinker, so I tend to zoom out a lot and consider the bigger picture.
What do you see as the main challenges in training the next generation of GPs?
"I think the challenges for registrars are similar to those being faced by general practice as a profession, namely the devaluing of generalism and all that leads to.
"We see a lot of drive within medicine for specialism and specialist interventions. The devaluing of generalist skills within general practice impacts the wider uptake in the profession as well.
"For teaching and training specifically, I'd like to think that most GPs recognize that we need to make the profession one that is attractive in the short and the long term. In the short term, better remuneration of GPs-in-training is certainly essential to increasing attraction to the training program. But this narrative has been taking trainees' focus away from quality training outcomes, which in turn rely on the longer term attraction, development and retention of dedicated supervisors and supervision teams.
Not all of us benefit from supervision as practice owners growing their future workforce; and constantly increasing demands on the supervisor's time - time that is almost entirely unpaid - makes me very worried about the future of primary health care in this country. There is a finite capacity for general practice to perpetuate without supervisors to pass their generalist knowledge and skills onto the next generation.
"On the one hand we’ve been working to elevate general practice, and the additional Medicare funding that’s come through has certainly helped buffer some of the issues within general practice broadly, but then there’s the opportunity cost for GPs involved with supervision and training.
"The expectation on GP supervisors is that we will deliver optimum quality in training and supervision. Our remuneration should simply align with this."
How would you summarise the challenges of greatest concern for our supervisor members?
"The majority of supervisors I've spoken to absolutely recognize that registrar remuneration and well-being is something that we should be able to address as a profession. At the same time, there is certainly a sense of frustration about the discontinuation of programs that worked in the past to build the pipeline of younger learners' intent on a future career in general practice, such as the PGPPP.
The GPs who serve as supervisors are genuinely motivated by a sense of community and the desire to contribute to the community they belong to. I think that's demonstrated through their involvement with the supervision of all levels of learner, bringing future GPs into the fold and fostering their passion for the profession.
"Generally there is a high level of willingness from most supervisors to be able to support their trainees as best they can and try to ensure that they continue within general practice.
"I often hear from supervisors and registrars on non-AGPT pathways seeking systems and policies that will enable the same quality and standards across all vocational training programs.
"There certainly is a broad acceptance that the distribution of registrars, and the GP training tools we have available to us at the moment, aren't necessarily all perfect. These are dynamic problems - trying to change things in one part inevitably has consequences in another part of the system."
What solutions is GPSA offering its members?
"GPSA has a very well established reputation and a track record of delivering best practice educational resources and tools. Our focus is on "how" to deliver high quality supervision, complementing the training provider's delivery of "what" supervisors should be teaching: whether the learners are medical students, prevocational doctors or registrars.
"To ensure our educational supports are evidence based, we run a wide range of research projects as a way to engage with our members and ellicit the key areas on which they want us to focus in advocacy as well as education. The interaction between education and research really makes what we do contemporaneous and fit for purpose.
In the last 2 years we have of course rebranded from GP Supervisors Australia to GP Supervision Australia, which highlights the value we place on all members of the training practice. Everyone plays a role in scaffolding the learner or trainee: not just the supervisor but also the practice manager, the new fellow, practice nurse, receptionist, everyone.
"We are building new Practice Manager resources to help with streamlining employment and documentation processes with the goal of freeing up this key team member's time to help the registrar maximise their earnings through effective MBS billings and to ensure the younger learners like medical students have really interesting, rich experiences in their GP placements.
"We have in this past year created a virtual community of practice (the GPSA Community platform) and empowered our members to network and draw on one another for peer support within their specific roles and regions. We have expanded our resources to readily accessible mobile apps and ensured we have a seat at every table across the sector.
"Perhaps the key benefit we offer our members is our independence. Being apolitical and College-agnostic allows us to represent an independent voice for training sites, supervisors and supervision teams."
What is your message to Australia supervisors?
I want to reinforce this: "GPSA is here for you. We're listening to what you have to say, and we will continue to represent you at every opportunity."