SUMMARY:
This professional forum invites general practice(GP) educators and trainers from around the globe to hear about and discuss the exciting opportunities the return of vocational training to the Royal Australian College of General Practitioners(RACGP) brings for the revival of primary care in Australia. The RACGP’s primary objective in building and implementing its training program is to train doctors to become the general practitioners the community needs. Attendees will hear about the build and early implementation of the training program and the challenges encountered. The forum will engage the audience to draw on their expertise in considering how to address the challenges the program faces, particularly the common tension between workforce need, educational need and trainee need.
The aim of the forum is to build understanding and new ideas in building GP training programs that will meet community primary care needs.

BACKGROUND:
In February 2023 the RACGP took responsibility for vocational training to achieve their fellowship. This represents the training for the majority of Australia’s future general practitioners. RACGP has based the build of their program on a review of current national and international best practice and work-based education theory. The program addresses the pathway from medical school into GP training which is critical for the future of GP. Currently only 15% of Australian prevocational doctors indicate an intention to enter GP training. The RACGP delivers training for urban, rural and remote GP and has a key objective of addressing the maldistribution of general practitioners. It has instituted case management and training pipelines to do this.
In order to deliver effective training, the RACGP has built a new syllabus and progressive competency profile. It has also built training frameworks for: Aboriginal and Torres Strait Islander cultural and health training; supervisor professional development and support; evaluation; and, work-based assessment.

1. Recognise the key imperatives and initiatives of the new RACGP training program
2. Achieve a deeper understanding of the challenges of delivering general practice training that meets work-force needs, educational needs and trainee needs
3. Take new ideas in training delivery to use in their own contexts

The Royal Australian College of General Practitioners (RACGP) is committed to developing and supporting a culturally safe and reflective general practitioner (GP) workforce that works effectively with Aboriginal and Torres Strait Islander patients and communities. A key strategy addressing Aboriginal and Torres Strait Islander health inequity is training that is evidenced to result in changing practice and in health outcomes (Reath, 2019). This commitment includes increasing the numbers of Aboriginal and Torres Strait Islander GP registrars.
In February 2023, RACGP transitioned to a profession-led training (PLT) model, and is directly responsible for the governance, management and delivery of all aspects of the general practice vocational training program. RACGP PLT brings an approach to educational structure and delivery that recognises Aboriginal and Torres Strait Islander health training needs from national, regional and local perspectives. To this effect the RACGP recognises the need to develop an Aboriginal and Torres Strait Islander cultural and health training framework (the Framework) which also builds on successful General Practice Education and Training (GPET) approaches to general practice training.
Aboriginal and Torres Strait Islander sovereignty and self-determination are integral to this Framework. We know that the impacts of colonisation, which is ongoing – dispossession, institutional and systemic racism, disempowerment – are main causes of ill health in First Nations individuals and lack of wellbeing in communities (Rigney et al, 2022). By acknowledging these realities and embedding Indigenous governance as part of this Framework, we seek to ensure that Aboriginal and Torres Strait Islander knowledge systems and ways of knowing, being and doing are grounding medical education and care within the RACGP.
By moving beyond a medical educational system that is rooted in a western focused bio-medical model, we can create a paradigm shift and achieve health equity through the unfurling of a sovereign vision for the future.

1. Understand why sovereignty and self-determination are essential to improving Aboriginal and Torres Strait Islander health outcomes 2. Reflect on how this Aboriginal and Torres Strait Islander Cultural and Health Training Framework shapes the work of the RACGP 3. Identify why cultural safety is integral to providing high quality, safe clinical care

The Clinical Competency Exam (CCE) is a multi-station examination that samples candidate competency across the RACGP Curriculum focusing on the application of clinical management skills in the context of Australian general practice. It is the final hurdle assessment prior to candidates obtaining fellowship.
The CCE represents an agile, contemporary, evidence-based examination. Extensive consultation with leading international medical assessment experts informed the development of this examination, ensuring that the assessment is valid and reliable, and enabling the RACGP to assess candidates’ clinical competence in multiple contexts, upholding the standard of Fellowship.
The CCE was developed in 2019 following a decision to review and update the longstanding Objective Structured Clinical Examination (OSCE). The COVID-19 pandemic accelerated the development of this exam with a transitional Remote Clinical Exam (RCE). The successful delivery of the RCE demonstrated that the “Show’s How” of Miller’s pyramid could be assessed virtually without compromising the attributes and quality of a face-to-face exam.
This presentation will showcase the theory, development and implementation of one of the largest successful online competency assessments worldwide. Developed and delivered in pandemic conditions and now to become the benchmark final clinical assessment of the RACGP fellowship.
The CCE has been observed internationally and our team continues to work with international partnerships to help our peers create contemporary assessments in primary care worldwide.

1. Discriminate and outline benefits of a competency-based assessment from an OSCE assessment.
2. Implement competency assessment to their own context.
3. Plan how to approach preparation for the CCE assessment as a candidate or supporting a candidate.