"'Poor is the student who does not surpass his teacher'… So my goal is to create doctors who surpass me," Dr Frank Maldari, GP Supervisor, Practice Owner, SLO and GPSA Board Director

Dr Frank Maldari is a well known GP Supervisor, Practice Owner, SLO and GPSA Board Director from South Australia.

Renowned for his, er, Frank-ness, GPSA's Communications Manager, Pauline Ingham, has prepared this article after a fun chat with GPSA's passionate Deputy Chair. 

How did you arrive at your role as GPSA Director and what do you think has brought you here?

"I've been a GP and practice owner for 35 years and have supervised students, interns, RMOs, and registrars for over 20 years. My passion for teaching started early, helping fellow students as a medical student and intern. This not only benefited them but also made my work easier—a win-win.

"As an SLO for the RTOs, I attended GPTEC conferences, where discussions with GPSA members further fuelled my interest in teaching and supporting other supervisors. Every 10 years or so, I seek new challenges, which keeps my professional life varied and engaging. So a role with GPSA became my next challenge.

"While I'm outspoken and honest, my focus is always on improving the quality of supervision and training for future GPs, without any personal ambitions in medical politics or organizational roles.

Ultimately, in Australia, we all need good doctors to look after us, myself included. My own GP is an ex-registrar of mine, which was a strong motivation for training registrars—to ensure quality care for everyone, including me and my loved ones.

"We all need doctors eventually, so let’s help develop the best ones we can!"

How have your various roles prepared you for your work with GPSA?

"As a practice owner and partner for 33 years, I have gained extensive experience in business decision-making, cultivating practice culture, and collaborating with colleagues to achieve the best outcomes for the business. This role provided a solid foundation in decision-making and management.

"My involvement as an SLO further broadened my perspective. Attending planning meetings with the RTO, sharing ideas, and participating in discussions shifted my focus outward. Before this, like many doctors, my attention was primarily on the business and practice. Engaging with the RTO allowed me to see how larger organizations operate, expanding my understanding beyond the confines of my own practice. This combined experience has been essential to my role as a Director of GPSA."

What challenges are currently of greatest concern to our members?

"One major challenge is recognizing the value of supervisors. High-quality supervision leads to high-quality doctors, which benefits the entire healthcare system.

Good supervisors help develop better doctors, who provide efficient care with fewer unnecessary investigations and referrals, ultimately saving costs and improving patient outcomes.

"Another significant issue is financial support. The hourly rate for supervisors hasn't changed in 20 years, despite rising costs. This has made it incredibly difficult to run a general practice. The lack of funding for training practices and supervision means supervisors are under immense stress, impacting the quality of training. The best supervisors still make the time sacrifice, but it's much harder now due to increased pressures and tighter budgets.

"The supply of registrars is also a critical problem. It's challenging to maintain a business model with only one registrar, whereas having multiple registrars and students allowed for better financial and educational outcomes in the past. The current setup makes it tough to justify the time spent on supervision.

"Patient pressures are another major issue. With long wait times for appointments, both supervisors and registrars are under constant stress to meet patient demands, which affects the quality of supervision and training.

"Additionally, external demands such as ticking boxes, filling forms, and completing programs like EASL take up significant time. EASL was a positive change but wasn't funded properly and didn't go far enough. Programs like ReCEnT data collection also add to the burden without providing direct educational benefits to registrars or practices.

"In summary, the challenges include recognizing the value of supervisors, financial constraints, registrar supply issues, patient pressures, and increasing external demands on supervisors. These factors collectively strain the quality of training and supervision."

What solutions is GPSA offering its members?

"Reflecting on who we represent, it's quite broad. Essentially, we encompass supervision in all its forms. Our advocacy focuses on increasing support for supervision, helping practices, and enabling supervisors to develop high-quality supervision.

"New supervisors, particularly, are a unique group. They're certainly fewer in number right now, but supporting them with the right tools is crucial.

Considering the average age of supervisors is quite similar to mine, we face a situation where we need to bring in younger, motivated individuals to sustain the passion and quality of supervision. They require robust support and resources to succeed.

"Supporting practice managers is another critical aspect of GPSA’s work. Practices and practice managers are often overlooked by Colleges and the Department of Health, despite being fundamental to training and scaffolding registrars. No one else represents training practices as GPSA does. This includes employment issues like the NTCER, where we support both practices and practice managers.

"Being responsive to the needs and concerns of practices and supervisors is vital. Many perceive GPSA as only dealing with the NTCER, but our remit is much broader.

"Our role extends to various aspects of training and supervision. There's competition in GP supervisor training delivery, but we see ourselves as augmenting the Colleges' efforts rather than competing with them."

What changes have you seen during your time with GPSA?

"Over the years, the training arena has become more pressured and complicated, with financial and other external challenges impacting practices and training alike. Despite this, GPSA has responded proactively. In the past seven or eight years, we've significantly expanded our influence. It's now much easier for us to get a seat at the table and be recognized, especially by government bodies. Being listened to and having our concerns addressed has been a major positive change."

How has GPSA effected these changes?

"It's been a lot of hard work, and I have to credit our CEO, Carla Taylor for her incredible energy and enthusiasm.

"Before her, Nicole Higgins did a fantastic job as Chair - as indeed Srishti Dutta is doing now -, elevating our presence significantly. Carla has taken that further, not by forcing her way into important conversations but by effectively arguing for our involvement and demonstrating the value we bring.
Carla's energy and focus have generated massive change. Under her leadership, our sphere of influence has expanded dramatically. We've developed new resources, launched mobile apps, created a board game, and explored opportunities outside our traditional space - broadening our horizons beyond just the NTCER.

"We've become more visible and recognized, which has allowed us to focus on a much bigger picture. Overall, we've grown bigger and better, with a broader interest and impact."

What would you like to say to Australia's supervisors?

"You've done very well, don't give up, and keep the faith.

Continue working hard and supporting your registrars to the best of your ability. Strive to make them better doctors than you.

"As I often tell my registrars, quoting Leonardo Da Vinci, 'Poor is the student who does not surpass his teacher.'

"I don't believe in poor students, so my goal is to create doctors who surpass me. After all, they are the ones who will look after us in the future."

Any final comments you’d like to share?

There is no doubt supervisors are under pressure, registrars are under pressure, practices are under pressure… but we still have the capacity to deliver high quality GPs for the Australian people. We just need support and recognition, and to be valued for what we do.

"There is huge potential for GP training to deliver high quality doctors in the future. We only need to work together to achieve what we need."