General medicine

I would like to begin by acknowledging the traditional owners of the lands from which we are all meeting today, and to pay my respects to any Aboriginal or Torres Strait Islanders who are joining us and to their elders both past, present, and emerging. One of the commitments of Queensland Health and indeed the College of Physicians is to advance indigenous health in Australia and New Zealand. And we've got a number of strategies to try to make that happen. We're not going talk specifically about them tonight, but very happy to answer questions or emails or discuss it down the track.

My name is Spencer Toombes. I'm a general physician and director of physician education at Toowoomba Hospital in Southeast Queensland. I'm very grateful to be joined by Dr. Liana Neldner, who has finished her general medicine training, but is now a rheumatology advanced trainee at Cairns Base Hospital. And she's here to provide a trainee perspective on the general medicine training program, but also a really important regional training perspective because you'll discover quickly, one of the things we're gonna try to sell you on tonight is the concept of regional general medicine and regional training.

Now, over the next 45 minutes to an hour, we're hoping to give you a brief introduction to what general medicine, advanced training looks like in Queensland. I'll talk to you a little bit about the training requirements and how to navigate the network. We'll show you some slides that outline the application process, but of course, that's backed up with a fact document and a bunch of stuff that you can find on the Queensland Health, RMO campaign and website and a couple of times as we go along. And certainly at the end of the talk, there will be opportunities for you to ask questions.

Now, because I'm hosting the talk, I can't monitor the chat very easily, but Ange will flick me anything that's critical and we'll certainly be able to close this down and look at the chat, at the end if you're gonna type in questions rather than to commit to asking them verbally.

Alrighty. So let's, let's talk a little bit about general medicine and advanced training in Queensland. So some of these slides have been updated since last year's talk. If you came last year, I hope you wouldn't, be necessarily doing it again but went to the IMSANZ website to see what they currently say about general physicians. And, and this is it. We're specialists, we're experts in the diagnosis and management of complex chronic and multisystem disease. We coordinate care, we work in multidisciplinary teams, we optimise health outcomes. We have a breadth of expertise, and that stretches from acute, undifferentiated very sick patients,  through to, ambulatory care, chronic illness. And our work is not limited by patient age, diagnostic category or treatment intent from the previous version of the curriculum from the college. In terms of training,  in general medicine, we are experts, experts at diagnosis, providers of integrated care, problem solvers, patient advocates, communicators, negotiators, innovators, system leaders, teachers and mentors. And when I look at this slide, I feel it's, it's pretty aspirational. There's, there's a lot of expert on that slide, but it's not far from the mark in terms of what, advanced trainees in general medicine, and particularly what,  general physicians are expected to do within hospitals. And as the role of general physicians has evolved over my practicing career in the last 20 years, we've taken on a lot more chronic illness management, a lot more undifferentiated or perhaps, difficult medical problems. And, a role is emerging or has, has emerged in terms of curating, what are often conflicting recommendations from our subspecialist colleagues whose knowledge and whose treatments have become so rarefied that, you know, an individual trainee with more than three problems is likely to get, opposite recommendations from, from different sets of doctors. And finding a pathway through or charting a pathway for our patients is something, that we are becoming expected to do.

I wanna talk to you a little bit about the spectrum of practice in general medicine in Queensland. And certainly if you are a regional or a rural general physician, there are all sorts of amazing and interesting jobs that you can do up on Cape York. You will find flying physicians who do outreach medicine across the very small communities up there, again on Cape York.

But in other places in Queensland, you will find solo physicians who live in regional towns or remote communities and provide, specialist medical care for that town and the surrounding area. here in Toowoomba where I work, I appreciate, I'm only an hour and a half away from the metropolitan of greater Brisbane. But our general physicians here do interesting stuff.

We have general medical inpatient units. general physicians run our medical assessment and planning unit, but we also have general physicians on our after hours endoscopy emergency roster, which reminds me, I'm unexpectedly covering for that this evening. So the phone rings of it's unlikely to in the next hour, but if it does, I may have to step away.

We have stroke physicians along with geriatricians and neurologists covering the reperfusion roster here in Toowoomba. when COVID was a thing, we were the COVID physicians, and general physicians provide perioperative medicine, obstetric medicine, and contribute to clinics in rheumatology and respiratory medicine. In addition to our own specialty.

We also supply the departmental directors for both general medicine and the medical specialties, elsewhere in the state, I'm aware of general physicians who do bronchoscopy or supervise chemotherapy or provide, crossover services with dermatology and infectious disease. So in the regional hospitals, general medicine is exciting,  and it also has a lot of crossover with formal subspecialty medicine, in the metropolitan centres, you will find lots and lots more subspecialists. And so general medicine there looks a little bit different. and the flavor of general medical units in hospitals is quite variable. Those of you who have worked at the PA and the Royal Brisbane, if you've managed to across the will realise that those are even in, in those two large metropolitan centers. The flavor of gen med is quite different but you will find in the metro areas, GE General Physicians doing acute medical units, MAPUs, perioperative,  care units, particularly in in private hospitals, hospital, in the home, residential outreach, hospital admission prevention programs, complex patients, multi-system disease clinics, and, you know, difficult disease, disease clinics, you'll find with niche expertise or indeed with dual training,  a lot of general physicians doing clinical pharmacology and running de-prescribing clinics, or involved in epidemiology, high level clinical decision making, health information systems and change management. So even by describing these attributes and these roles, I'm sure you've come to recognise that being a general physician involves developing a really complex and diverse set of skills you need to bring to bear both in the administration space and in the patient care space. And, and this presents a problem, the, those of us who train general physicians, because you've got to ensure that when you give someone an FRACP in general medicine, that they can do one or, or any of these jobs so that they're, that they're, they're qualified to get stuck in.

You could ask yourself the question, how do I train? Or I ask myself the question, how do I train someone for these roles? where in Queensland are they going to train? Where in Queensland are they going to work? And so for the College of Physicians, when they construct the curriculum that sets the, the minimum standards for training or for Queensland Health, when we've built the general medicine advanced training network, we have to think about pushing trainees through a series of training experiences to acquire specific skills across these areas.

So let me talk about the key players in this space. Obviously at the center we have the, you, the, the trainee, the person who wants to become a general and acute care physician. And you, you've got at least three sets of interactions there. The college sets, the curriculum and the standard, each individual hospital will be your employer and provides your training setting. And then we have the general medicine training network, which much like the basic training network with which many of you're on now is a Queensland Health Construct. and it's designed to provide a transparent access point for everybody stepping in. So you only have to interview with one group of people for all of the jobs in Queensland. and a mechanism for distributing trainees across those, those jobs in the state. making sure that people, both the, the hospitals and the trainees, get the workforce that they need. But that the trainees in the process of providing that workforce get the training experience that they need.

Alright, that leads me to talk briefly about the new curriculum. And when I checked this slide this morning, I typed a little caveat on it saying that the new curriculum details are yet to be published by the College of Physicians. But literally an hour ago I received a big official email from the, from the RACP saying, it's a go ahead. The freshly constructed curriculum for advanced training in general medicine, will be engaged for the 2026 cohort. And so those of you applying for advanced training and signing onto our network for training from 2026 will be subject to the new curriculum. Those trainees already on the network, or who have trained,  started training elsewhere overseas or, or in other states, will continue on the old curriculum. That's a very much a college policy is that new curriculum doesn't disadvantage old, old or former trainees. but if you are signing up for the first time, the new curriculum will be the go.

A lot of the stuff in the new curriculum will be, fairly familiar. It's been foreshadowed for a period of time, but there, there are some significant changes to term requirements, and I'll discuss those now. So when you do advanced training, you're looking at a minimum of three years of training. So if you're gonna do a single specialty such as general medicine, that's a three year training program. There are a couple of slides in a minute about dual training,  which depending on the training specialty that you can do, and you can condense down to four years by taking two, two, lots of three and, and overlapping one of the years within the three years of advanced training, two years,  need to count as core training time. And within that, there's an expectation that one term will be six months, which will be a change from basic training.

You can sometimes get four month terms accredited, and if you're doing a term part-time,  in terms of, flexible training, you need a three months of full-time equivalent part-time to count as a core term. But in two years of training, college would anticipate four core terms within those four core terms. The new requirements are a minimum of 12 months of core general medicine. And then in the next 12 months of core training, a minimum of one, six month term of a core subspecialty. And by core subspecialty, we're talking about a specialty that is not general medicine. and then the other six months can be done in a general medicine like specialty and general medicine like terms include things like, eruptive medicine or obstetric medicine, for example. There's a list of those on the college website. this represents a change in the, in the old days it was 12 months or six months of core general medicine, six months of general medicine like, and two subspecialties. The change fundamentally recognises that there are a bunch of trainees coming through who have not done very much core general medicine before they step into advanced training. For those trainees, this new requirement is handy 'cause they will get good, good quality core medicine. if you've already done a shed load of general medicine as part of your basic training, 12 months is not a huge ask given that you've got two additional years of training that you can fill up with subspecialty exposure. So let's quickly talk about the one year of non-core training.

Now, unfortunately, when, when I wore a training supervisor hat for the college, unfortunately there was, there was an an attitude for some trainees, which I really wanna strongly discourage, which is that core training, non-core training is not important. nothing could be further from the truth. Non non-core training is there, not because it's unimportant, but because the college wants to give you flexibility to get the kind of training experiences that you want to craft yourself into an effective physician. So taking care of that non-core time, making sure that it adds value to your training, really, really important.

So in this period of time, you might do 12 months of a dual training specialty. Talk about that in a moment. You can do an extra six months of a core term if you wanted to really improve your exposure in a particular subspecialty. Or you could do two additional core subspecialties if you wanted to increase the breadth of your specialty experience. You could use this year to acquire or polish a procedural skill. and the other thing that I haven't talked about is that in the course of your three years of advanced training, you need a minimum of six months of an acute term. And with acute medicine, the college is defining, fairly clearly, it is all about being able to manage, physiologically unwell patients. And so the, the classical acute medicine term would be an intensive care term. And clearly that's not for every, not everybody wants to do that. So you can often make up acute time in some stroke units in a coronary care unit, and in some MAP-units or, or general medicine units, depending on how much, on-call, how much cardiac arrest time, how much met team time, the sorts of things that ensure that you are seeing and, and taking the lead in managing physiologically unstable patients.

Alright, let's talk about a couple of other considerations. both the college and the network strongly recommend to the extent that we're essentially saying it's a minimum of two different hospitals. And when you're choosing two different hospitals, I would also encourage you to choose a hospital that's different to where you did the majority of your basic training.

Different hospitals have different moods, different vibes, different ethoses, different ways of doing business. And, moving between hospitals, is a very good way to experience different ways of doing things. And to, to increase your exposure to, experience you’ll be better for it and to be careful about night shift, the colleagues lets you get away with a couple of weeks of night shift. And certainly, when I was a trainee back in the back in the 20th century, advanced trainees of all stripes at many hospitals would squeeze a couple of weeks of nights in to, to make up the roster because we, we worked in hospitals where there simply weren't enough basic trainees to fill in all the nights. And the college would let us get away with that. But it won't count the night shift as advanced training.

I am aware that there are some roles, I'm gonna say the epic role at the Royal Brisbane and some other hospital at night roles at the Gold Coast and elsewhere which have been accredited as night shift. And if you're doing nights as part of your ICU term, that's, that's usually also counted as core. But with those important exceptions, nights don't count and many hospitals will make sure that their advanced trainees don't do any nights at all. With the new curriculum comes a new set of curriculum assessment tools and assessment requirements. You probably haven't experienced this in basic training 'cause it's only the 2025 cohort of basic trainees who are beginning with their new tools. But, these learning captures and observation captures are a, there's gonna be more of them, but they're meant to be less onerous and easier to do using the trainee management platform. And this is, and again, the goal is around competency-based medicine, frequent, formal feedback to guide trainees rather than getting all of your feedback, every six months in a huge piece of paper and a conversation with your supervisor.

We're also formalising a thing called a learning plan which is where you start the term by carefully looking at what the learning experiences are going to be, having a conversation with your supervisor about that we're still using supervisor reports, which are the primary form of a summative assessment. And over the course of the three years of advanced training, there is an expectation that you will do one high level advanced training research project. And again, there's a whole chunk of the college website devoted to what that looks like one project and three years doesn't sound like much, but suddenly two and a half years of your training have gone by and you haven't started it, then it can be a real barrier to getting your fellowship.

So we spend a bit of time talking to new trainees, in their first year about how they can plan and prioritise their project going forward, because we don't want that to be a barrier to qualification. Let's quickly talk about dual training. So dual training requires a minimum of four years of training. And when, again, Liana may choose to comment on this because she's done some general medicine training is now doing rheumatology training. If you wanna squeeze it into four years, you really have to plan ahead. because the idea is that the non-core time for your subspecialty is used during core time for your general medicine and vice versa in order to plug it all together. And if you don't think about this at the beginning, very hard to get all of the ducks to line up in a row. I should point out that there are a couple of specialties, specifically cardiology and nephrology, where the nature of those curricula mean that you will require five years to complete dual training if you choose to do it that way.

When you're picking core specialties, really important that you achieve breadth as well as depth. So if you are doing a dual trained specialty, make sure that your additional general medicine specialty is something different. You don't wanna be doing all respiratory and then try to tell a college that your sleep term is your separate subspecialty or doing gastroenterology and tell 'em that your hepatology term is, is something different,  much better to get something that's, that's completely different and achieves a good breadth as well as depth of knowledge.

Alrighty. So the critical thing here, before I hand over to Dr. Neldner is to be planning your training. Apart from planning, get on a training plan. What sort of physician do you wanna be? Are you gonna be a regional physician with a procedure? Are you gonna be a regional procedure? But a, a physician with a heavy emphasis on point of care ultrasound orperioperative medicine? Where is it that you want to work? And if you're gonna work there, what skills are you going to need to be an asset in that environment? How are you gonna acquire those skills? And where in the course of your training are you going to acquire them? And how do you line up your desires, your opportunities for improvement? Your strengths, lined up with the current college requirements? And when it comes to the question of where you are gonna acquire those skills, I cannot advocate enough for regional training within Queensland as being a good place to do your training.

And with that said, I'm gonna hand over to Liana who will talk to you about the benefits of regional training. I'll just sing out and I'll change the slides for you. Thank you, Spencer.  So hello everyone. My name's Liana Neldner. I've just put my email address down the bottom of that first slide. So I'm happy to be contacted if anybody has any questions about, you know, general medicine, advanced training or regional training. I have done 18 months of my general medicine training up in Cairns. And I also was fortunate enough to do six months of a junior consultant,  gen med job, at Nambour Hospital, which is kind of borderline for regional, but is,  kind of a special rotation you can do with one of the scholarship programs. So that's what training I've done. And I have not done dual training in an efficient way. I've done full three years of general physician training. And I just thought the more training the better. 'cause you can constantly learn more. so I am a general physician, but I'm also,  starting to learn some rheumatology as well. You can change the slide. Thanks, Spencer.

So benefits for, for training in terms of going somewhere regionally. So up in Cairns, we are very fortunate to have very interesting medicine, and we find that a lot of the regional sites,  have what, what some people refer to as, I guess real general medicines. So, the subspecialties don't necessarily have admitting rights. So, so here rheumatology doesn't have admitting rights, and the neurology team won't take as many patients as they would at some of the other hospitals, which means, you get to keep those skills up as a general physician looking after patients with undifferentiated conditions. And yeah lots of interesting medicine. The population can be quite different.

So in Cairns, we have quite a high first Nations population. And that also comes with quite late presentations often, with unwell people as well as tropical medicines. So you know,  melanoid infections, and you see a lot more meropenem use than you probably do down in Brisbane.

The other benefit of I guess going regional, is you get some op options for unique rotations. So I was fortunate enough to go on the outreach medicine rotation as a general medicine advanced training trainee. And so, these are all photos from my trips. I think Spencer added one from his trip back in the day as well. so the first photos of flying into Thursday Island, in the Torres Strait, where we go do, a clinic on one day, stay overnight, take a boat to Bamaga, which is the most northern part of Australia, do another clinic there, and then take the boat back, and do stay another night, do another clinic, and then fly back. And then you can see that small plane as well was when we flew to one of the other smaller communities, Lockhart River on the Cape as well. And then we're just able to provide some expertise and support to the rural GPs who work out there.

And I guess it's a really good opportunity to see,  you know, where people come from who, who then present unwell to the hospital, as well as, you know, the challenges, that are faced in regional and remote medicine. The other thing is there is a gen med advanced trainee scholarship program, which can allow you to do some kind of extra funded positions. So I did a, as I mentioned, a general medicine consultant role, where, because I had extra funding, I was able to have my own, basic physician trainee reg as well as a resident and an RMO to really, I guess, help build confidence in, before I stepped up to being a general physician, running a general physician team.

There are also other roles Spencer mentioned, you know, you can potentially learn skills such as learning scopes, but that just needs to be, I guess, arranged in advance. The other benefit,  for training is that often you can take up leadership roles. You work very closely with the, with the consultant general physicians and can really step up and take on some of those extra roles, whether it's planning for things such as, I helped organize the IMSANZ conference up here in Cairns, or whether it's we also do a few running, MET simulations for BPTs and RMOs.

So there's lots of opportunities 'cause you're really embedded and, you know, work closely with, with the general physicians. as I mentioned, it's also good for understanding the challenges of regional medicine if you're, if you're working in, in Brisbane and looking at,  you know, patients coming from these pace places far away, if they need complex surgeries,  and you're looking after them on periop, it does help to know where they're from.

And then a few of my other friends have mentioned, that the commutes are much shorter, which can help. And sometimes it can be easier to get subspecialty rotations that you want. you can change the slide. Thank you. and then specific benefits for you as well, is that you get to see a bit of Australia. So, this is one of the waterfalls we hike to. There's lots of beautiful country around here, especially if you like the outdoors and reef,  workplace cultures. So the hospitals,  are smaller, generally, friendly, very easy to talk to. other specialties about consults or, or complex patients. it's also quite social. I mean, I'm not sure what they do in Toowoomba, but,  you know, some of the social events here, you'll have the consultants regs down to, you know, interns and med students all, all going to the same events. So,   that's always nice to have a good hospital culture. And,  and then,  sometimes there's, Commonwealth funding, which, for certain positions, which can give you some extra money to go to your conferences, and, PDL or do courses, which, can just help you I guess, a little bit financially given, often you are a little bit further out of the city. But happy to take any questions if anyone has any.

All righty. So as I said, we can't see the chat just yet, but if you want to, if there are any burning questions, just, unmute and jump in. Otherwise, we'll keep talking and there will certainly be an opportunity for questions at the end.

All right, we're gonna quickly plug on. So next I wanna talk to you about the network. And essentially the, the reason we've got a network, apart from the fact that Queensland Health was, kind enough to fund this in the sort of post Patel period in the early two thousands when, when there was a little bit of money kicking around for, for teaching and training,  is to provide a centralised transparent criteria based multimodality rank order and allocation process for trainees who wanna be general physicians. And because general medicine is really important to Queensland and to regional Queensland in particularly, we've got roughly 60 new positions that we can squeeze trainees into across the state each year.

And so like geriatrics, which is another big recruiter, that means that general medicine often becomes a position that people apply for while we are waiting for the one immunology training position in the whole of the state,  for a period of time. but there's also usually a chunk of people who apply to us because general medicine is their passion and that is what they want to be. And our selection and allocation process is designed to look after  both of those groups of people. Now, the critical thing is that because there are lots of hospitals in Brisbane and lots of hospitals in regional Queensland, network trainees still need to plan their training.

You need to think about where you want to go, what skills you're gonna acquire when you go there. All of the hospitals that have accreditation with the college for general medicine advanced training are listed on the Queensland Health website. And in that document, or  the document that you will find on the website, you'll see that each of those hospitals has what they regard as the advantages of coming to their hospital. I'll tell you what, what they're good at, what terms they can guarantee for general medicine advanced training, what terms they can often supply, that might not be guaranteed, but with a conversation and some planning can be put together. There are some coveted positions around, particularly for some subspecialty terms and particularly for some high level, metropolitan hospitals.

And because that competition is significant, you need to be aware that the majority of positions in those hospitals will go to trainees who are already on the pathway because we allocate them for their training needs before we allocate new trainees but even their positions for first year trainees are allocated at all of the metro hospitals in Brisbane. But for that reason, you need, if you are stepping onto the network to have a conversation with individual departmental directors, not to interview for a job, not to, not to tell them how good you are, but to have a communication with them about what your training needs are and whether their hospital can supply those training needs.

And the contact numbers for those departmental directors or departmental representatives are also included in the paperwork on the website.

So let's talk quickly about QIMEP, which is the Queensland Internal Medicine Education Program. This is led by the GMATs registrars and other senior registrars across the state who form a committee to decide what the education program should look like for advanced training in general medicine. And they run a fortnightly lecture series on Wednesday evenings, which is recorded and made available to those people who didn't wanna sit together and eat pizza on a Wednesday night. The goal is to make these lectures practical and clinically relevant. but they also do professionalism and employment related topics, and at least one of those in the early part of the year will be training related, for example, telling you how to get your research project underway, and make it happen. QIMEP is quite a popular program, because it's registrar led, and the basic trainees, you, you've probably already encountered it in using it.

Liana has mentioned GMATs; the S stands for scheme rather than for scholarship. Every time I accidentally use the word scholarship, I get, thumped by Vicki or Ange, because it, yes, it is a funding pool and it kind of feels like a scholarship, but it technically isn't, but essentially we fund five supernumerary positions per year. The program is set up as a two year program for each trainee. So the first year is not supernumerary funded, but is mentored. And we, you have a conversation about what your training is looking like, and then in your final year of training, we provide supernumerary funding. And that could be very useful for getting difficult to obtain training perhaps procedural or special skills, and particularly useful for getting those junior consultant roles in,  smaller, regional hospitals. there is an annual application process, and if you are a first year gen med advanced trainee, that is the year to be looking at this scheme, thinking about what your next two years of training should look like and putting an application in.

This is the mandatory slide about flexible training. So both the RACP and Queensland Health over the last 30 years have recognised that we actually need to have flexible training, because we need it. Unfortunately with time-based training, and I know that the college is making noise about moving to competency-based training, but fundamentally, it's a hybrid model and your time of exposure is still what they're looking at doing flexible or, or part-time training prolongs duration of your training. And that can be, that can be hard work.

Some hospitals, I'm looking at you Logan, are really good at this because they've got stuck into it earlier but practically every hospital in Queensland, if you have a conversation with the Director of Medicine and the director of advanced training there, they will bend over backwards to, to make flexible training work for you. So I encourage you to be, if that's, what you're looking at needing talk to someone and we will do our very best to make it happen.

I'm gonna jump over this, question section 'cause there's only a little bit to go to get us to the end of this talk. So here are the important dates and the how to apply. And there's a lot of detail on these next few slides that you don't need to copy down. because realistically, if you put advanced training General Medicine Queensland Health into your favourite search engine, it will take you to the relevant page on the Queensland Health, outward facing, webpage with all the facts and the documents and the bits and pieces on it, the important dates to these.

The campaign opens on the 2nd of June. The campaign closes on the 30th of June. I appreciate most of you will not have your exam results back by then. and so it's always a frustration as people, you know, not sure whether they're applying to advanced or basic training and how, and you kind of hedge your bets with the RMO campaign. Rest assured you are not alone, there are people who will answer emails and we will sort this out, as you progress through. So essentially the RMO campaign,  as frustrating and annoying as it is to interact with and as, as vastly as important as is that Queensland Health crack on and rewrite it to make it useful. It is what it is and make it work. So get onto the campaign.

When it says, are you applying for the General Medicine Advanced Training Network, select yes. And then that will, hopefully either the network logic drive you to a series of questions and uploads for you to, to apply to our network. You need to upload evidence of planning for general medicine advanced training, which involves your CV. and there is a short statement indicating your plans for, for training and plans for practice when you finish your advanced training. And both of those will be assessed by general physicians in Queensland as part of the, as part of the network process. You can preference up to six hospitals. and again, I'm gonna, the next slide will show you a list of, of the available hospitals.

Very important that you discuss your proposed application both with the Director of General Medicine at the hospital. We are currently working because they would be an ideal referee for you on the program. But also with the top three preference hospitals so that when your application is successful and we come, very quickly after interview to the allocations meeting. Those, hospital directors know who you are, what you want, and importantly they can, they and you are both assured that their hospital will meet your training needs for your first year.

These are the training locations, and again, I won't read this off. You'll notice that Redlands have now have, have officially separated. So Redlands, Gold Coast and Robina, used to be linked. In fact, in the old days they were even linked with Logan. But as Logan Hospital and Redlands Hospital have built larger general medicine training programs, they have now separated from the Gold Coast/Robina combination, and they're now separate hospitals to apply to.

I would've put a plug in there, particularly for North Queensland. So both Townsville and Cairns were places where I did my advanced training and they were spectacular experiences and, and very, very high quality training. Also put in a plug for Toowoomba Hospital 'cause that's where I'm currently working. If you're applying to Sunshine Coast,  bear in mind that it has Nambour Hospital and Private Hospital,  as potential placements and both Greenslopes and Mater Hospital, because they are private hospitals involved, suspending your Queensland Health employment to do 12 months in a, in that private hospital. We make sure we have processes in place to ensure that you don't lose your long service leave or other benefits that you might be accumulating as an advanced trainee elsewhere.

Next, at step 10 in the pathway involves nominating a training program preferences. And so you need to say that your facility is College Pathway Network, determined that the position is registrar, the specialty is medicine, the subspecialty is general medicine advanced training. and consider somewhere in your six preferences, including a PHO in medicine or the basic training network, in case you are not successful or indeed in case you need to do the switch reading.

Remember, there is flexibility within the program to change your preferences up until quite late to allow for those random chances of the college exam and other factors.

We'll talk quickly about dual training. So if you are a dual training applicant, and this, this slide becomes slightly less relevant now that COVID has finished. And we've done a little bit of a better job of linking up with the other subspecialties to not overlap our interview times. But if you preference general medicine as your first preference, we will assess your application and we will interview you for a job. If you make us your second preference associated with geris/pall care, clin pharm or obstetric medicine, we guarantee that those people will get assessed and get an interview. But if we are your second preference for other specialties looking at you, cardiology, gastro, neuro, depending on our interview availability, we will merit rank all of those candidates and offer them an interview only if we have capacity. And in the last couple of years, we've had capacity to interview everybody but that is not a, we can't guarantee capacity for every single dual training applicant.

Having said that, get some referees. Ideally they need to be, well, not ideally, they need to be people who can comment accurately on your skills and experience. And ideally, they need to have worked with you in the last 12 months, check the spelling of their email address. It's critical that they get it.

Ultimately we will do a multimodal assessment of your referee reports, your cv, your short statement. And then we've done an online format, multiple mini interview for the last five years. It works pretty well. You've experienced something similar when you applied for basic training. the interview dates for this year are the 19th and 20th of August. And generally you'll have plenty of notice that that's coming. You won't need necessarily to take a day off, but you will need a quiet room with good internet access to make that happen.

We are nearly at the end of the talk, but these are the selection criteria agreed by the directors of general medicine across the state when we set up the network. And they're pretty self-explanatory and I'm not gonna read them out 'cause they are listed on the website. But when you are crafting your short statement and when you are thinking about what the MMI, multiple mini interview questions are going to contain, knowing what the selection criteria are and dwelling on them is an important thing. And so if you are submitting an application that has a CV that says at the top of it, my dream is to become a cardiologist,  then you're not gonna do very well on that first criteria, which is commitment to a career as a general physician.  Just saying that's one of the clues.

But when you're, when you're preparing your application, alright, there we go. Allocations successful candidates will get a 12 month allocation for training hospital. that employing hospital will arrange your contract. We encourage flexible work practices and flexible work placements.  If that is what you need,  let us know early. If you need extended leave, for example, parental leave, please let us know early. you know, gone are the days when people are not gonna employ you because they don't want someone who's gonna need parental leave, for example. That's, that's illegal. and we've, we've gotten quite good at stamping it out. So the sooner you let someone know about your rostering preferences and your rostering needs, the easier it is for us to, you know, find a, matching part-time trainee or to, make plans for your extended leave. So, talk to people earlier about that, please. there is a process for applying for your next hospital, and people who are on the network are allocated prior to people who are new to the network. but that still requires conversations with directors of general medicine and planning around what terms you're going to do.

Alright, here we go. The second last slide. These are the summary of today's talk or, or hopefully are firstly, plan your training. Think about what sort of general physician you want to be, what the skills are you're going to need, how you're gonna require them, where you are going to acquire them,  what are, what that looks like in a three year plan. Communicate your intentions to your local director of general medicine and to the people at your nominated hospital so that they know what you look like and they know what your plans are and they know whether or not those plans can be accommodated within their training. Read the selection criteria of the website, before you submit your short statement and ideally before you plan out what your CV is gonna look like.

And I, lastly, I would, and Liana would strongly encourage you to consider regional training and ultimately regional careers because the general medicine is different and I would argue better outside of metropolitan Brisbane. That's all that I have and that brings us to questions, but I'm gonna stop sharing the screen so that I can open the chat window at this point. If you have questions feel free to put your hand up or throw it in the chat and we will do our best to answer those questions for you.

Alright. It might be a first, we've been so thorough. No. Ah, okay. We have a question saying, can you join the network later in the year? Well, the answer is that it kind of falls into the flexible training. So a late start, or an early start, there is a provision for people to apply for training halfway through a year if they have completed all the requirements for basic training and if the hospital that they are at has capacity for advanced training and they sit our process, then you can, you can sort of get a jump on other trainees and start six months early. If you need a late start for some reason, I would encourage to apply to the network, get accepted, selected onto the network and then promptly, you know, ideally even before you get selected, communicate when you are going to be available to start. Clearly hospital rosters are built around a 12 month process from the 1st of February. but with notice, we can accommodate people starting late. Certainly my hospital has done that in the past.

Sorry, I just, I missed that last bit that you said. Did you say that you would apply as if you're applying for BPT or as if you're applying for at, if you were like thinking of starting in the last six months of the year? Again, I think it depends, if you are, have you finished the requirements for bt?

No, because my requirements will probably extend till next year, which is why I was wondering.

Yeah. Okay. Look, in that circumstance, I think one of the requirements for applying is that you have completed basic training. So if you or, or will have completed basic training by the beginning of 2026, so in that circumstance, I think you will need to apply for basic training to complete your basic training. But if you are going to complete basic training in the first half of 2026 and the hospital that you are working at has vacant advanced training capacity, then there is a process for mid-year entry onto advanced training that would involve applying as a 2027 cohort but commencing training mid 2026. So that's if, if you, that make sense.

Thank You. Yeah.

If you have not, if you are not going to finish basic training by first February 2026, you are not eligible for this year's, allocation unfortunately.

Alrighty. Well we must have been unusually thorough I think or possibly effusive with respect to regional Queensland. So thank you all for your attendance. This presentation has been recorded and will be available on the Queensland Health website and feel free to reach out to us either. Liana’s left her email if you want some personalised advice, or you can reach me through the physician training email, through the Queensland Health website. Angela will forward all of that through to me and I'll get back to you as soon as I can.

Thank you and good evening.