An update on the jurisdictional Single Employer Model (SEM) pilots

• Queensland Health is collaborating with local hospitals and rural generalist programs to embed training opportunities and create flexible career pathways for healthcare professionals; improvements for 2025 include stronger application criteria and explicit financial guidelines, based on lessons learned in 2024
• The NSW Rural Generalist Single Employer Pathway has grown significantly, with future plans focused on expanding training and increasing GP participation
• South Australia's Riverland Academy of Clinical Excellence (RACE) has successfully integrated training and retention, creating a sustainable pipeline for rural generalists
• Separate from RACE, South Australia has expanded its SEM trial across multiple LHNs, optimizing resources and standardizing processes
• Tasmania’s statewide SEM model has supported rural GP training, with ongoing efforts to secure a formal rural generalist pathway and ensure long-term program viability
• Victoria's SEM trial is showing early success in boosting recruitment, improving collaboration, and increasing training site engagement. The next steps involve resolving contractual complexities and expanding participation 
• WA is awaiting approval for its proposed trial (delays caused by caretaker mode through state election)

The registrar perspective offered some interesting considerations for the jurisdictions to address going forward:

• Overall, registrars see SEM as a promising option with significant benefits, particularly in the early stages of their medical career, though some uncertainties remain about long-term career implications.
• Positive Aspects:
  - Provides better financial security, especially in the first 6-12 months
  - Higher hourly rate compared to traditional billing models
  - Access to comprehensive teaching and learning opportunities
  - Regular teaching sessions for RACGP
  - Continuous professional development
  - Access to Newswatch and local teaching
  - Wraparound support, including maternity leave considerations
• Challenges:
  - Potential earnings differences after the first 6-12 months
  - Uncertainty about long-term financial benefits compared to traditional billing
  - Communication gaps and feeling disconnected from decision-making processes
  - Concerns about career progression and momentum
• Key Registrar Observations:
  - SEM is particularly beneficial for those starting in general practice
  - Provides more structured support during initial training phases
  - Addresses previous disincentives like loss of continuity during maternity leave
  - Offers a more stable employment framework compared to traditional GP training model.

When asked whether the Commonwealth's election promises for registrars (starter incentive and parental leave) would have impacted their choice of SEM, the response mainly focused on the fact that "4 or 5 full days in general practice is just too hard" and having the balance across hospital and clinic was "easier"...