Requirements For Physician Training
Guidelines For FRACP Training in Ambulatory Settings
These guidelines apply to physician training in Ambulatory Settings from August
2005.
- Ambulatory care comprises the bulk of clinical work for many physicians.
Training in ambulatory care is considered essential, in order to prepare
physicians for subsequent practice, and to enhance understanding of the natural
history
and the need to refine treatments longitudinally in a wide range of clinical
condition(s).
- Ambulatory training embraces the care of all non-admitted patients,
through a variety of service models, including traditional outpatient general
and specialty clinics, private consulting practice, day admissions, dialysis,
and community practice, including home visits. 'Opportunistic' ambulatory
care often ensues from following up Emergency Department referrals. Basic
physician
training should include a minimum of 4 hours / week (ie at least 10% of
clinical work) in ambulatory settings. Advanced training will usually entail
considerably
more because of the importance of longitudinal care and the wealth of experience
derived from managing intercurrent problems.
- At least part of the exposure to ambulatory care should include
the typical ‘Rooms’ consultation model.
- Ambulatory practice importantly should maintain an active interface
with referring hospital staff and community practitioners both hospital
and community based. Timely correspondence and telephone communication conveying
all essential information are a minimum expectation with all forms of ambulatory
care.
- All new and complex review cases should be discussed with a consultant,
in order to optimise patient care. This would ideally be conducted at the
time of patient assessment or alternatively at weekly review meetings.
- A supervising consultant should periodically observe the trainee’s
interview and clinical examination skills along with a sample of clinic letters
(at least 3 monthly is recommended) and provide constructive feedback.
- A resume of clinical letters and summaries should be retained (for
example, in the trainee portfolio during Advanced Training) by the trainee
and form part of formal hospital and RACP term evaluations.
