PS01 Recommendations on Essential Training for Rural General Practitioners in Australia Proposing to Administer Anaesthesia
AUSTRALIAN AND NEW ZEALAND COLLEGE OF ANAESTHETISTS
ABN 82 055 042 852
RECOMMENDATIONS ON ESSENTIAL TRAINING FOR RURAL GENERAL PRACTITIONERS
IN AUSTRALIA PROPOSING TO ADMINISTER ANAESTHESIA - 2010
1. INTRODUCTION
There are areas of Australia where geographical circumstances preclude referral of certain types of surgery, and where there are no specialist anaesthesia services. Such areas require general practitioners (GPs) to be administering anaesthesia. Where possible, general practitioner anaesthetists (GPAs) should work in co-operation with resident and visiting specialist anaesthetists.
The College acknowledges the role of rural GPs by its membership of the tripartite Joint Consultative Committee of Anaesthesia (JCCA), in partnership with the Royal Australian College of General Practitioners (RACGP) and the Australian College of Rural and Remote Medicine (ACRRM).
The JCCA oversees the training, examination, and ongoing accreditation of rural GP anaesthetists. These practitioners must have appropriate training and must be administering anaesthesia safely. This training is fully outlined in the Rural Training Curriculum, endorsed by the JCCA.
It should be clearly understood that this College professional document is not intended in any way to endorse, reflect on, or prejudge the issue of surgery being undertaken in rural and remote areas. Furthermore, the question of hospital facilities and infrastructure is crucial to this matter, and anaesthesia is only one of a number of considerations which must influence any management decisions to be made in the best interests of the patient.
2. OBJECTIVES OF TRAINING
The objectives of the training of rural general practitioners proposing to administer anaesthesia are as follows:
2.1 To provide general knowledge, experience, skills and competence in the management of common anaesthesia procedures (especially anaesthesia for obstetrics), in resuscitation, in pain management, and in the early management of severe trauma.
2.2 To provide specific knowledge and practical skills as they relate to rural GPAs, including relevant aspects of general medicine, surgery, paediatrics, obstetrics, intensive care and pain management.
2.3 To provide understanding and insight for decision-making about local management, further consultation and referral for anaesthesia and related procedures.
2.4 To develop skills to act appropriately as a member or leader of a therapeutic team, to contribute to the education of nursing, paramedical and medical staff, and to conduct clinical audits, research and quality assurance activities in their anaesthesia practices.
2.5 To ensure a commitment to self-directed learning and other forms of continuing education in anaesthesia, to adaptability to changes in anaesthesia practice relevant to safer management of patients, and to act according to ANZCA recommendations on rural general practitioner anaesthesia practice.
2.6 To foster a commitment to rural general practice anaesthesia where sufficient specialist anaesthesia services are unavailable.
3. TRAINEE SELECTION CRITERIA
The following criteria are recommended for selection of GPA registrars:
3.1 Completion of two years’ postgraduate experience in a recognised Australian general practice training program.
3.2 Successful completion of the Early Management of Severe Trauma Course (EMST), the Effective Management of Anaesthesia Crises (EMAC) course, or a secure position within a future course.
3.3 Demonstration of relevant anaesthetic knowledge, skills and experience including, or similar to, a resident medical officer at the end of a term in anaesthesia.
3.4 Demonstration of a commitment to rural general practice, including experience of at least one term in rural general practice.
4. TRAINING
A minimum period (12 months full time equivalent [FTE]) of supervised training is required.
This training should preferably be part of the General Practitioner Training Program of the RACGP, or the Vocational Training pathway for Fellowship of ACRRM.
This training should be:
4.1 In accordance with current JCCA regulations
4.2 In the Department of Anaesthesia of a hospital accredited by ANZCA or by the JCCA. (If training has been undertaken overseas, there are certain conditions to be met by the trainee on his or her return to Australia before commencing practice in anaesthesia.)
4.3 In accordance with the Advanced Rural Skills in Anaesthesia Curriculum of the JCCA
The curriculum allows for two periods of attachment:
4.3.1 attachment to a Department of Anaesthesia in a hospital as in 4.2 above (nine months minimum)
4.3.2 three months of the twelve months may be an attachment to accident and emergency, intensive care, or a rural anaesthesia practice working with a JCCA-accredited anaesthetist.
5. ASSESSMENT
An examination is conducted following the training period. This consists of confirming a satisfactory log book and supervisor report, and a viva voce examination.
6. ACCREDITATION AND MAINTENANCE OF KNOWLEDGE AND SKILLS
General practitioners should maintain their anaesthesia skills and knowledge by undertaking an ongoing case-load, and by participating in continuing professional development (CPD) in the field of anaesthesia. This should be in accordance with a CPD program endorsed by the JCCA. Practising general practitioner anaesthetists who have not completed JCCA training may apply to the JCCA for assessment of equivalence.
Relevant documents:
• Advanced Rural Skills Curriculum Statement in Anaesthesia
• Curriculum Statement for Anaesthesia. Australian College Rural and Remote Medicine
• Joint Consultative Committee on Anaesthesia: Maintenance of Professional Standards Program
• Joint Consultative Committee Anaesthesia: Training Regulations
ANZCA professional documents
ANZCA professional documents are progressively being coded as follows:
TE Training and educational
EX Examinations
PS Professional standards
T Technical
POLICY - defined as 'a course of action adopted and pursued by the College'. These are matters coming within the authority and control of the College.
RECOMMENDATIONS - defined as 'advisable courses of action'.
GUIDELINES - defined as 'a document offering advice'. These may be clinical (in which case they will eventually be evidence-based), or non-clinical.
STATEMENTS - defined as 'a communication setting out information'.
This document is intended to apply wherever anaesthesia is administered
This document has been prepared having regard to general circumstances, and it is the responsibility of the practitioner to have express regard to the particular circumstances of each case, and the application of this document in each case.
Professional documents are reviewed from time to time, and it is the responsibility of the practitioner to ensure that the practitioner has obtained the current version. Professional documents have been prepared having regard to the information available at the time of their preparation, and the practitioner should therefore have regard to any information, research or material which may have been published or become available subsequently.
Whilst the College endeavours to ensure that professional documents are as current as possible at the time of their preparation, it takes no responsibility for matters arising from changed circumstances or information or material which may have become available subsequently.
Promulgated: 1981
Reviewed: 1986, 1991, 1997, 2002, 2010
Date of current document: Aug 2010
© ANZCA professional documents are copyright and cannot be reproduced in whole or in part without prior permission.
ANZCA Website: http://www.anzca.edu.au/
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