An idea on what is going on in a general practice consult.

Uncategorized Oct 18, 2018
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Being a GP Supervisor... Extra demands and staying sane...

Uncategorized Aug 24, 2018

One of the other GP supervisors has been away for two days, so I've been looking after two registrars.

It is a interesting experience - just in taking all of the phones calls, and fully experiencing the demands that are placed on GP supervisors.

It's definitely an extra level of skill set that's required compared to not being a GP supervisor.

I think one of the big challenges is the interruptions.

Leaving the case where I'm dealing with my patient, then going and sorting out the other patient that the registrar's working with...

How do I help them sort out their patient?

How do I help the registrar to learn?

How do I make sure that they're safe, make sure that we're not missing anything?

Then coming back and then hopping back into my patient and helping them.

It's quite a demanding experience, and the hope is that despite this I can still go home confident that I've done my work for all my patients, as well as provided a growth experience for the registrar.

So how am I...

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OSCE No1 Question

general practice Aug 15, 2018

Okay, hi, it's Tom Rolley here for Graduate Medicine.

I've just completed my day and it was a pretty good day.

We had some interesting cases, but what I wanted to talk to you about is that some of you may be approaching the final hurdle in your path to fellowship, which of course, is the OSCE.

And if you're going to pass the AKT and pass the KFP, then you might think, "Hey, this OSCE thing, it should be pretty easy."

And you'd be right, because of course it is closest to how we actually work.

Yes, it's a little bit stylized, because it's eight minute cases, or it's the two long OSCE cases, which are 19 minutes.

But, you still need to know how to perform well, and also of course, it is quite a serious investment.

I think it's up around $4,000 plus mark at this point.

It's a long day as well, so you really want to have the capacity to step in confident, and actually know that yes, your money is well invested into getting this for RACGP and you've put the time in so you pass!


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Examination Performance

general practice Aug 05, 2018

Well, hello everyone.

I'll see if the signal works.

I just got home.

It's been a long day because I did a nursing home visit and also a visit to one of my patients who's had a crush fracture and is recovering in her home.

So it's like ten past six, it's date night and I'm going to take my wife out for dinner tonight .

If you're a GP and I'm going to strongly recommend you try out weekly date nights to preserve your relationship with your significant other, your wife or your husband or whoever that is in your life.

I'm finding it pretty helpful so that's the first tip for tonight.

What I wanted to cover is how exam performance can be impeded by poor preparation across clinical knowledge, critical skills and clinical reasoning.

So I was talking to a doctor yesterday and he said, "You know, Tom, I've know I've failed 2018.2."

I said, "Well, how can you know that?" And he said, "Well, the night before I hardly slept."

So I said, "Okay. What happened there?"

And as we dug a little...

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Success with the APHRA petition.

general practice Jul 30, 2018


Hi, its Tom Rolley for Graduate Medicine.


Just checking in with the good news.

I received an email this morning that the petition that I spoke about last week has been successful.

Now, for those who are unaware, this petition covered a rule whereby any complaints, whether founded or unfounded, would be registered on the a doctor's record.

So the petition target was 15,000.

I'm not sure exactly how they got.

Actually I do...

It's 16,640 signatories to it, and if you click the link it will say "Congratulations. Medical board reverses policy."

So this is clearly a win for common sense, and also respecting the work and the challenges we face as GPs. So, very excited.

If you did sign the petition, thank you.

It's an interesting experience of the world that we live in, that when we combine signatures or work together, we actually get results.

Alright, that's all I got for today.

Very happy that common sense has prevailed, and look forward to seeing you again...

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Different Experiences with two GP consults.

general practice Jul 30, 2018

So.. I had an interesting experience.

On Wednesday I was consulting.

The patient came in and said, "Gee, Tom. I think I've got Addison's."

Now if you're a GP or GP reg, you would realize that it's probably relatively unlikely.

So I go, "Great. I'm going to cut across to my key feature checklist," and I found no Addison's disease.

And I'm like, "Ahh, this is no good. What happened to my Addison's disease?"

So it's in production...

We haven't got it out yet.

But I then was stuck with the issue of going, "Okay, now I have to go to Murtagh's, I have to look up the web what's going on. Okay, that's right.

This is what Addison's about."

I got through it and I good reassure them  "I don't think you've got Addison's."

"But what was left for me, is the initial usefulness of the key feature checklist, if it had been there, was something that really powerful... I was like, "Damn, okay I've got to keep working on these things."

Now, today I had a different experience, which...

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My Health Records

general practice Jul 26, 2018


I thought I'd jump in on another topical discussion at the moment.

Thanks to everyone who supported the AHPRA petition!

Let's talk about My Health Record.

So that's been transferred from an opt-in system in Australia to an opt-out.

So, If you don't opt-out in the next 11 weeks then you will automatically get a My Health Record created for you.

Now the word on the street is, I don't have direct evidence of this, but many GPs are not opting in for this.

They are opting out.

And yes, indeed, I am opting out too.

I don't see a lot of upside benefit for myself.

I don't have any chronic diseases, and yet the downside risks include identity theft, and I'd already opted out by the time that the Singapore data theft had occurred.

If you're not aware of this, 1.5 million records were taken.

Now apparently, there's no health records stolen, but just people's date of birth and all of their identifying information.

Now, if that's not a risk for identity theft, then I'm not...

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Sign the petition

general practice Jul 24, 2018

It's Tom Rolley here for

I wanted to jump in around a petition that you hopefully know about.

If you don't, then this is to bring your awareness to this petition.

Now, this petition is about AHPRA going ahead with an idea that they will basically publish all complaints against doctors, even if those complaints are investigated and are found to be false and ridiculous or whatever's going on, that they're not actually saying anything wrong was done by that doctor.

They're still going to go ahead and make that complaint against that doctor's name on the register on the AHPRA website.

So this petition's saying, "Hey, this is ridiculous. How can you publish this stuff against a doctor when there is not even anything that they did wrong?"

Now, and you might think, "Oh, well, most complaints are actually legit, they are all going to be upheld."


According to doctorportal, where I was sent this link from, they say at least 70-plus percent of these are dismissed,...

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GraduateMedicine - Twilight 2

fracgp exam Jul 24, 2018

Hi and thanks for joining me on this training.

My name is Tom Rolley for Graduate Medicine.

First of all I'd just like to put out a massive congratulations to everyone who got through their exams on the weekend.

What I want to touch on today is this second Twilight Zone that you may find yourself in, which is between the end of the AKT through until results come out.


Now that the OSCE requires not just a pass for the AKT, but also the KFP... it's almost I think a four week gap from now until you know that you've passed AKT/KFP and that you can enter into the OSCE.

What is the risk at this point?

The risk is that it feels like you've been through this massive journey, got through KFP, got through AKT and I'm done, I'm collapsing down.

It can feel like, "Oh my goodness, I'm done! I don't have much left in the tank"

But do not forget there's still one more exam to come.

My interpretation of the entire exam thing, is the best way to do it is to actually run through and...

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GraduateMedicine - The Twilight Zone What to do between the KFP and AKT Exams

fracgp exam Jul 23, 2018

Hi, Dr. Tom Rolley here for Graduate Medicine.


I'm just finishing up my week and I've been sitting here completing a bunch of paperwork - one of the joys of general practice!


Nonetheless, today, was the KFP exam.

I want to talk about one of the challenges that previously hasn't been in the exams, which is what to do between the KFP and the AKT.

Previously, they were either on the same day, or people consciously choose to split them by six months.

So , there wasn't this semi-twilight zone, 18 hours between finishing the KFP and then taking the AKT tomorrow.


What I want to talk about is the potential for whatever happened for you in the KFP is done, and you can't go in and alter those results.

You don't know what those results are.

But the risk is that it affects your confidence for tomorrow's exam.


What I wanted to look at is the possibility for how do you still maintain your focus and calmness through this period.

Because there's is still work to do...

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