1. What is Vocational Registration, and why was it introduced?

Vocational Registration (VR) for general practice was introduced in 1993, in an attempt to improve professional standards and reward high quality practice. It also gives recognition to general practice as a discipline, or even a specialty, in its own right, rather than just a 'catch all' grouping for doctors who are not surgeons, physicians, gynaecologists etc.

Being a VR GP gives access to special Medicare item numbers and higher Medicare rebates, which translates into a higher income.

GPs with VR are required to fulfil the RACGP Quality Assurance & Continuing Professional Development (QA & CPD) criteria in order to remain vocational registration.. This involves a combination of educational activities and assessment/audit of practice which is completed in rolling 3 year periods (triennia).
Please keep a good record of your attendance at all CPD activites.

Importantly for OTDs, Fellowship of the RACGP, and full registraion there after will enable an application for Permanent Residency to be made. Thus it is a crucial step on the road to long-term stability and security for your life and practice in Australia.

2. How is it obtained?

The process is set out in detail at the RACGP website.
The most common method for OTDs is to obtain Fellowship of the RACGP via the Practice Route. Some overseas GP qualifications are recognised as having status by the RACGP. In each case, the doctor must have a minimum of 5 years GP experience, a minimum of 1 year of which must be within Australia.

It is possible to enrol in the assessment process with a total of 4 years GP experience, but the Fellowship can not be granted until the 5 year mark. The RACGP Censor-in-Chief is responsible for deciding what constitutes GP experience. Note that there is a fee payable for this assessment process.

Candidates for Fellowship must also pass the Fellowship examination. ( Multiple sitting are allowed if requried.)

In order to sit this examination, you must have:

1) current medical registration,
2) be a current financial member or associate of the RACGP, and also
3) have completed a basic CPR course within the last 12 months.
4) Be able to show record of CPD activities in that time.

3. The Fellowship examination has two components

1. The Written Component
   • AKT (Applied Knowledge Test) 150 questions to be completed in four hours
     
   • KFP (Key Feature Problems) 26 questions to be completed in three hours.
2. The Clinical Component
   • This consists of approximately 17 stations, 14 active stations and three rest stations. It takes approximately four hours.
     
     

   Details about the exam can be found at
   www.racgp.org.au/exam/
   The Examination handbook can be downloaded as a PDF document from a link on that page.

You may also wish to consider formal preparation for the Fellowship examination, details of which can be found at:
www.gplearning.gpea.com.au/other_education/fellowship/index.html
It is expected the doctor will meet the full cost of the fees themselves. The cost is likely to be somewhere between $3000 and $10,000, which is a substantial investment, but should be viewed in the context of the benefits that Fellowship provides, and is recognised as a high-quality process with good outcomes.

A small number of OTDs may be granted Fellowship without further assessment. This applies only to those with specific GP qualifications from New Zealand, Canada, Ireland and the United Kingdom. These Doctors can apply via "Fellowship Ad Eundum Gradum."
In mid 2008 the fee is approx $995 including membership for a year.

4. Practical Advice & Resources

You may have noticed by now the frequency with which the RACGP has been mentioned already. Joining the RACGP as a Member or as an Associate is effectively mandatory.

However, in addition to being a requirement for the Fellowship examination, it also offers a number of useful benefits. General practice in Australia is different to that in any other country, although of course some countries have more similarities than others.

Being part of the RACGP means that you will receive the College journal, Australian Family Physician, which is an excellent window into GP life and standards in Australia. It also offers useful, practically-oriented articles, usually grouped into themed issues of the journal, as well as discounted prices for a range of books and educational activities.

If you are, or intend, practising in a rural or remote area, you may also wish to consider joining the Australian College of Rural & Remote Medicine (ACRRM). ACRRM also offers valuable insights into the special features of rural practice, as well as delivering education on line and hosting specific educational events.
The ACRRM home page can be found at: www.acrrm.org.au/

The most widely respected textbook is John Murtagh's 'General Practice'. This can be found on amazon.com or some University book stores.
John Murtagh is a towering figure in Australian general practice, with many years of rural experience and a long academic career. The format is user-friendly, and it cannot be recommended highly enough.

Other useful texts include:

1. 'General Practice: Companion Handbook', also by Murtagh, or
   
   
2. 'The Oxford Handbook of General Practice' by Chantal Simon, also available on amazon.com. Whilst this is not specifically Australian, it is still full of useful information, and would be useful for doctors returning to general practice after a period of time out of the profession, or working within a sub-specialty.
   
   
3. The Internet is also the source of a vast amount of information, some of it of a very high quality, and some less so. Without attempting to be an exhaustive list, the following sites are recommended as being useful: www.gpnotebook.co.uk
   
   
4. A good all-round information site and on-line text. Free of charge. www.jr2.ox.ac.uk/bandolier/
   Well-written and sometimes quite witty articles and summaries about evidence based medicine. Quite a lot is available free on line, and more can be had by paying an annual subscription.

If you are registered with an Australian Medical Board or the Medical Council of New Zealand, you may join Ausdoctors.net without charge. Aside from giving you Webmail access, this will also provide free on line access to several electronic textbooks, Medline searches and the Cochrane collaboration. The home page is at www.ausdoctors.net

If you are not eligible for Ausdoctors, but do have United Kingdom GMC registration, their parent site (with all the same services) will allow you to join at: www.doctors.net.uk

You may feel rather overwhelmed, and also concerned about the time demands and costs that will be incurred. Remember that you don't have to accomplish it all in the first 6 weeks after you arrive in Australia!
Indeed, in most cases, you cannot apply to commence the process any earlier than 12 months after you begin working in Australian general practice.

Whilst not wishing to minimise the process, you should bear in mind that most doctors who begin this process pass without undue difficulty. This is true for Australian and overseas trained GPs.
RAD's experience is that our doctors have a first time pass rate for the Fellowship exam of about 75%. It is likely that many of the costs that you incur will be tax deductible here in Australia, although you should seek professional advice in that regards before claiming a deduction.

Once you have successfully obtained your Fellowship of the RACGP, you may be justifiably proud of having passed a rigorous assessment process, and being part of a body recognised internationally for its excellence.