GENERAL MEDICINE
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SUPERVISING COMMITTEE

Definition

GENERAL PRINCIPLES

COMPONENTS OF TRAINING

Core/Non Core Training, Rural/Regional Training and Procedures

Project or Case Reports

Other Specific Requirements

Research

Training Sites

Other Training Programs

SPECIAL SOCIETY

Vocational Training
 General Medicine
The following guidelines apply to those trainees commencing their first year of advanced training in General Medicine from 2007 onwards:
2007 Guidelines - last updated 9/10

Supervising Committee
Specialist Advisory Committee (SAC) in General Medicine.

Definition
A general physician (in New Zealand they are often referred to as specialists in internal medicine) is one whose training and expertise enables practice as a consultant in the broad field of internal medicine as it applies to adolescents and adults. General physician practice adopts a specific approach to the patient as a whole person, notwithstanding an interest and training in a particular field. General physicians have a breadth and depth of knowledge and experience which makes them ideally suited to provide high quality specialist services across a spectrum of health and illness which is not limited by the boundaries of medical subspecialties. These capacities place general physicians in an important and responsible position as both clinicians and teachers, particularly where problems are undifferentiated and complex, where there are issues which do not fall within the range of subspecialties and where the integration of interdisciplinary expertise may be required.
General physicians have important linkages with colleagues in many disciplines including general practice, surgery and psychiatry.

General Principles of Training

  1. Advanced training in general medicine must conform with the guidelines for advanced physician training which can be found in this website.
  2. Career training in general medicine involves the formulation and successful completion of a carefully constructed and balanced program approved prospectively by the SAC, aimed at fulfilling the definitions and recognising the need to acquire clinical, teaching, research and administrative skills.
  3. It is recommended that trainees attempt to plan ahead for the whole 3-year period, whilst maintaining some flexibility.
  4. All training programs will include active supervised clinical work in general medicine or in accepted medical subspecialties.
  5. Programs may be constructed to allow supervision and training for periods in other disciplines such as dermatology and psychiatry.
  6. Advanced trainees are also advised to obtain a copy of the Guidelines for Members and Advanced Trainees in General Medicine published by the Internal Medicine Society of Australia and New Zealand (IMSANZ).
  7. In Australia a maximum of 2 years may be spent in any one subspecialty. In New Zealand a maximum of 18 months may be spent in any one subspecialty under the supervision of the SAC. The option of post FRACP training is available for those who wish to obtain further experience in a subspecialty after the completion of advanced training in general medicine. Trainees are strongly encouraged to consider this option.

Components of Training
The minimum 3 years of accredited training will include a 2 year period of core training and a further year of non core training devoted to gaining proficiency and further experience in clinically related fields or in a research program.

Core/Non Core Training, Rural/Regional Training and Procedures
General medicine does not define specific core or non core periods or a particular procedural content to training. Advanced training in general medicine is considered more than the sum of periods spent in diverse subspecialty areas and a minimum of 12 months in Australia (6 months in New Zealand) should be spent in units under the supervision of physicians practising general internal medicine. General physicians have a requirement for some depth as well as breadth. The SAC encourages trainees to develop interest and expertise in one or 2 subspecialty areas.

Experience in ambulatory consultant physician practice is encouraged. It is desirable that training takes place in more than one institution to acquire a broad base of exposure and experience. Periods of training and service within non metropolitan institutions are strongly encouraged.
The SAC supports trainees who seek to undertake part of their training in regional or larger rural centres. Such training would be suitable for either one year or 2 years of advanced training. One of the 3 years of advanced training should be spent in a non rural hospital.

In Australia advanced training programs in general medicine in non metropolitan centres are available in Queensland, New South Wales and Victoria. These programs will enable trainees to develop procedural skills appropriate to practising in regional or rural centres. In New Zealand trainees are strongly encouraged to spend 6-12 months in a smaller hospital e.g. hospitals outside Auckland, Hamilton, Wellington, Christchurch and Dunedin.

Adequate supervision is available in regional centres and most of the larger rural centres, and many opportunities exist for varied and interesting project work in this specialty. The CAT in Australia or the Chair of the SAC in New Zealand is prepared to advise individual trainees on request of the opportunities available in particular centres. Information can also be obtained from the Manager, Rural Workforce and Advanced Training Unit 02 9256 5444. New Zealand trainees should contact the New Zealand Office on 04 472 6713 for further information.

The SAC does not currently mandate trainees to keep logbooks as part of accreditation although the concept is a well-developed requirement in other subspecialties. General physicians frequently perform gastrointestinal endoscopy, bronchoscopy and echocardiography. General medicine trainees who wish to obtain such expertise as a component of training would be advised to consider the requirements of the CCTGE, the guidelines for gastrointestinal endoscopy, bronchoscopy and echocardiography published by IMSANZ and the procedural requirements of other SACs/JSACs. Trainees are advised to have such procedural expertise carefully supervised and documented.

The SAC will consider prospective approval of the program for the year, or part of the year, in which the examination is attempted. Periods will only be accredited after success in the examination if the SAC is satisfied that the preparation in no way interfered with advanced training.

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This page was last edited: June 2011