In Australia, 8.7% of babies are born prematurely. Preterm birth is the greatest cause of death and disability in children aged up to 5 years in the developed world. Pre-eclampsia affects 3.3% of pregnancies. It can lead to significant maternal and neonatal morbidity and, less commonly, death. Gestational diabetes affects 15% of pregnancies and is associated with a seven- fold increased risk of affected mothers developing diabetes later in life. Neural tube defects are relatively rare in Australia, with 0.22 per 10 000 births per year affected. However, they can result in significant disability and death.

There have been several advances in recognising women at risk of these conditions. Once recognised, there are numerous interventions that can be offered to reduce the risk of developing these conditions. However, many of these interventions need to occur in early pregnancy, often prior to women encountering tertiary health services.

GPs, midwives and other health care workers have an important role in identifying these women. In doing so, they can reduce the risk of maternal and fetal morbidity and mortality and reduce health care costs. However, given the number of risk factors, and the complexity of advice to be offered, this task is not simple.

This risk identification tool aims to simplify the task of identifying women at risk of these conditions and provide guidance about further management if risk factors are identified. The long term aim of this project is to have this tool linked with practice software and with referral to antenatal services.

To address the biggest health threat facing humanity, it is imperative that education enabling the medical workforce to understand, address, and mitigate the health effects of climate change is integrated into all levels of medical education.

RACGP declared a climate emergency in 2019, released a position statement on climate change and health, and this year have signed with 9 other medical colleges to the Healthy Climate Future campaign. As the college takes over general practice training, there is a unique opportunity to focus on incorporating climate ready and climate friendly practice into our training.

My Future Leaders project presents a model for collaboration in climate change and health education that could be adopted and tailored by the RACGP.

We started as a local university student-Faculty volunteer collaboration to map climate change to the organ systems model of first year medical teaching creating a Planetary Health – Organ System Map - which is an easy to use resource for clinical teaching across all organ systems.

We now support student groups and medical educators across Australia and have collaborations with prevocational training organisations to integrate climate change into their clinical teaching.

Through this process, a collaborative education community has emerged. I will present how RACGP could use this model, teaching resource and community of practice to support the training of GPs to practice climate friendly and climate ready medicine and achieve their vision for general practice as part of a sustainable healthcare system.

The ACT Health GP Policy Forum will be held in October 2022. The goal of the forum is to promote a genuine exchange of information and experiences between the ACT and surrounding region GPs and the ACT public health and hospital system leaders. It is designed to add to my wider work of improving engagement and communication with ACT GPs, as the ACT Health GP Policy Advisor. Although primary care is Federal funding responsibility (which adds to the complication of working as a GP in government at a Territory level), I believe that best policy takes into account the whole healthcare system, including General Practice and primary care.

As nearly every GP working in Victoria is aware, there are significant issues associated with public hospital referrals, mostly delayed triage as well as referral rejections. In particular, urgent referrals that are not assessed and reported back to GPs in a timely manner are a focus of concern. This project aims to find the failure points in the intra-hospital referral processing system and advise health divisions about identified improvement opportunities; the primary improvement endpoints being patient safety and receiving the best medical/surgical care in a timely manner.

In this regard we will liaise with Eastern Health to review their triage and acceptance process and try to find the failure points together and then agree on improvement recommendations; in future we can discuss this model with other health divisions across Victoria, with the aspiration to adapt the model to individual systems.

Moving across countries as a medical practitioner has a number of challenges. To make this transition easier for foreign doctors wanting to contribute to the Australian medical system, a series of webinars was created with the RACGP International team. This series addresses questions from the time before the move such as registration, pathways to orientation, cultural differences, peak professional bodies and the ins and outs of working as a GP in Australia amongst others. The on-demand availability on the RACGP website is aiming to make this a useful resource for current and future IMGs.

Migrant doctors (nomenclature used by colleges IMG/OTD) make up for over 50% of the current GP workforce as per RACGP Annual report in 2019. In addition, the 2019 Deloitte General Practitioner workforce report (1) highlights the following regarding the supply of GPs:
If we then look at the GP and other health organizations as well as common media or traditional audio-visual mediums / social media platforms, the terms like “leader” or “representative” are not often associated with migrants or particularly migrant female GPs, and even less so to those who may describe themselves as person of colour POC (defined also as Culturally and linguistically diverse).

It is no surprise that when we discuss engagement and participation in the GP/health organizations from these groups, we hear they are disengaged, lack a sense of belonging and do not feel seen or heard. Rather than tackling this with questions, more surveys or statistics, I would hope to use stories to connect with people who may help us discuss some of the intangibles that exist amongst these narratives.

Improving diversity within GP leadership roles, influencing perceptions regards IMGs and recognizing the significant contributions made by them to Australian primary care form the core purpose and goals of my Initiative. By hosting a podcast and inviting migrant GPs who have created an identity for themselves and are willing to share their trials and triumphs to help influence the journey for others, I intend to get the conversation started that will help address this.