Types of rotations
RACGP: The rotations required for RACGP are: general medicine, general surgery, emergency medicine and paediatrics. In addition to these, you need to complete three voluntary rotations relevant to general practice. Examples include psychiatry, obstetrics and gynaecology, geriatrics and anaesthetics.
ACRRM: The rotations required for ACCRM are: general surgery, general internal medicine, obstetrics and gynaecology, paediatrics, anaesthetics and emergency medicine.
If you complete all the required rotations before your second year, you should try to choose others that will help you in your career as a GP.
Location for rotations
You have control over where your registrar training takes place. This is an opportunity to break out of your comfort zone and move away from where you have already trained. If you’re considering a career in rural general practice, this is your chance to give it a trial run.
The first few days.
Your first experience may be a detailed account of everything you want to know, or it may be a little shorter and more to the point, but regardless of which you receive, keeping an open mind and asking the right questions will hold you in good stead with your new colleagues and keep you well-informed of your responsibility.
Ask your supervisor or the orientation leader:
- What will my timetable be? Who is my supervisor?
- What is the best part about working in general practice for you?
- What challenges can I expect to face?
- What academic texts can you recommend?
- What are the required courses and assessments during my placement?
- Would you mind giving me a quick tour?
- Who else in the practice/hospital can I contact to assist with my learning?
- What are the local services/clinics I need to know about?
- Will I require IT access?
In addition to this, find out who the more tenured students are and approach them for tidbits about their first steps in your shoes. Having recently experienced what you are going through, they will be a great wealth of useful information.
If your placement is in an Aboriginal Medical Service or somewhere that services an Aboriginal and Torres Strait Islander community, make sure you have been provided with appropriate cultural training. In lieu of this, make sure you know who you can ask when you have questions related specifically to Indigenous culture.
Know your limits.
As part of your orientation time, you need to find out what you will be expected to do as part of your interactions with patients. You will not be expected to understand or be capable of doing everything straight away, so understanding what is expected of you and where your limits lie is important. This ensures you will have a clear framework for learning.
Some tasks you might expect to be asked to perform are:
- Gathering and presenting medical histories
- Writing patient notes and referral letters
- Handing over patients and arranging subsequent check-ups
- Basic triage and vitals checks
- Calling on patients from the waiting room
- Immunisations, wound care, plastering, pap-smears and other nursing procedures
- Educating patients on basic health care
- Explaining pathology, ECG and spirometry results
Make sure you have the resources you need to continue research, coursework and assessments. Your placement may include the use of company-provided computers and Internet, but you may also need to provide a laptop of you own. Check on this before you begin your placement as this will be crucial to your success.
Know the benefits.
If undertaking a rural placement, you may be eligible for reimbursement of some of the costs associated with relocating. This may be in the form of a grant or claiming of transport or fuel costs. Again, check on this before you begin to make sure you are not unduly out of pocket for expenses incurred.
Regardless of your placement, you may also be provided with accommodation. Again, do the research before you begin your placement. Call your potential locations and ask them whether there is provided accommodation, where it is located in relation to the hospital, what is included and how it works. This will make it easier when you arrive.
Take notes, ask questions and seek feedback.
You may have one supervisor or you may have many. Whichever structure you fall under, feedback will be vital to your success in your time there. If you do not receive this as a standard part of your day or week, ask for it. There is no shame in wanting to understand how you are performing and what (if any) areas you need to improve within.
To assist you in asking for feedback and in your learning overall, make sure you are always taking notes. The more you write down, the easier it will be for you to review and ask direct, pointed questions of your supervisor. Vague recollections of patients and activities will not garner the detailed feedback you require in this situation.
Most importantly, and integral to everything within your placement, ask questions. You are there to learn, and if you don’t ask supervisor what you want to know, they may not be able to explain it to you. Communication is a big part of your time here and the more probing, direct questions that you ask, the more beneficial your experience will be. 
Display professional conduct
Remember that while you are there to learn, the patients and their symptoms are very real. Take care to be respectful, kind and helpful, and make sure you supervisor knows about it. Your best learning will be in the hands-on experience of working with patients. If you’re not sure, ask. It’s what you’re there for, after all!
Remember, your rotations are part of your training for your chosen profession. Be aware of how you present yourself; make sure you are professional, courteous and hygienic at all times. A good demeanour and appearance will go a long way towards gaining the trust and respect of staff and patients during your time with them.
Take care of yourself
A common issue for people who work in any care-giving environment is compassion fatigue, also known as Secondary Traumatic Stress (STS). This can develop when someone sees high volumes of patients or clients. It can lead to reduced compassion, stress, sleeplessness and a decrease in productivity. Keep in mind the following preventive measures:
- Maintain a healthy recreational schedule. Take regular breaks, and establish clear professional boundaries to ensure your work does not bleed over into your day-to-day life.
- Keep a wide and varied social circle. If all of your social contact revolves around your colleagues, you will have no respite from the pressures of work.
1. “Guidelines Optimal GP Placements” Chris Timms for GPSN National Council. March 2012.