Terms and Conditions Benchmarking Survey Report 2010

GPRA’s Terms and Conditions Benchmarking Survey Report 2010

Table of Contents 1. Survey Background & Objectives ..................................................................................................... 2 2. GPRA’s Terms and Conditions Benchmarking Survey 2010: Brief Summary of Results ............... 3 3. Key Areas to be Addressed .............................................................................................................. 8 4. Limitations of the Research................................................................................................................ 9 5. Survey Methodology ........................................................................................................................ 11 6. Demographic Profile of Respondents ............................................................................................. 13 7. Detailed Findings .............................................................................................................................. 16 7.1 Employment Conditions: Arrangement Registrars Have with their Employers ........................ 16 7.2 Billing Profile and Earning Capacity............................................................................................... 20 7.2.1 Autonomy in Choosing How Patients are Billed ................................................................. 20 7.2.2 Registrar Billing Profile ............................................................................................................. 22 7.2.3 Weekly Earnings, Sessions Worked & Per Session Earning Average ................................. 23 7.2.4 Registrar Remuneration Structure ......................................................................................... 27 7.3 Negotiating Terms of Employment ................................................................................................ 36 7.4 Preference for a NMTC Document for GPT3 ................................................................................ 44 7.5 Compliance with the NMTC Document for GPT1 & GPT2 Registrars ........................................ 48 7.6 Educational Release Time ............................................................................................................... 52 7.7 Sick Leave, Annual Leave, Public Holidays and Other Leave ................................................... 54 7.8 Additional Work outside Training Program ................................................................................... 57 8. Appendices....................................................................................................................................... 59 Appendix A – Weekly Registrar Earnings: Results from GPRA’s Training Time Survey 2010 ........... 60 Appendix B – Survey questionnaire...................................................................................................... 61 Appendix C – Verbatim responses provided at Q37 (Overall levels of satisfaction) .................... 70 Appendix D – Verbatim responses provided at Q41 (What would assist in negotiating employment contracts)......................................................................................................................... 72 Appendix E – Aspects of work that are paid by condition employed as ...................................... 76

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1. Survey Background & Objectives The purpose of GPRA’s 2010 Terms and Conditions Benchmarking Survey was to benchmark the salaries and employment conditions of GP Registrars currently working in Australia.

In helping Registrars understand what other Registrars across Australia are being paid, GPRA hope to empower Registrars to negotiate the best terms and conditions for themselves.

In addition to assisting Registrars to negotiate their employment contract with their practice, the survey results will also inform the development of some negotiating guidelines for Registrars. Accurate data on Registrar income will also be useful data to better inform interested students and junior doctors.

Another key objective of the benchmarking survey is to assist GPRA to be better equipped to negotiate on behalf of Registrars with the National General Practice Supervisors’ Association (NGPSA) on the National Minimum Terms and Conditions for GPT1 and GPT2 Registrars document (NMTC) which is being reviewed in 2010. GPRA also foresee the survey results will assist medical practices and supervisors to understand what they may need to offer Registrars to be competitive.

Finally, the results also provide some measure of compliance (and non-compliance) to the current NMTC document amongst employers and RTPs across the nation.

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2. GPRA’s Terms and Conditions Benchmarking Survey 2010: Brief Summary of Results As would be logically expected, the further Registrars get into their training, the better their employment arrangements and conditions appear to get. The findings indicate that the earning average of a full-time GP Registrar in Australia is $274 per session, while earning potential increased from $248.60 in GPT1 to $331.50 in GPT3.

Table A: Average Weekly & Sessional Earnings All Registrars Average earning per session Average weekly earning

GP Term GPT1

GPT2

GPT3

Extended Skills/ Special Skills

$274

$248.6

$258.8

$331.5

$325.7

$2,192

$1,914

$2,148

$2,354

$2,573

The earning per session average does not differ markedly between general ($276) and rural ($264) pathway Registrars, nor between full-time ($270) and part-time ($293) Registrars.

There was an appreciable difference between the weekly and sessional earnings between male and female Registrars with males earning a higher amount, as illustrated in the table below.

Table B: Average Full Time Gross Weekly & Sessional Earnings – Male versus Female

All Registrars Males Female Average earning per $274 $287.5 $259.7 session Average weekly $2,192 $2,645 $2,311 earning

For ordinary hours, most Registrars either earn “a base salary or percentage of billings, whichever is greater” (46%) or they are paid only “a percentage of billings” (33%). Amongst those who are paid a percentage, it is more common than not (58%) that they are paid more than the minimum 45%. It is good to see that a Registrar earns a higher percentage of billings the further into their training they are; whilst almost three-quarters of GPT1 Registrars are paid 45% (72%) the majority of GPT3 Registrars (86%) are being paid at a higher rate.

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Table C: Percentage of Billings Paid – by Term Currently In Term Currently In All Registrars GPT1 GPT2 GPT3 40% 0.7% 0.0% 0.0% 1.5% 45% 41.7% 72.2% 60.7% 12.3% 50% 26.6% 19.4% 27.0% 26.2% 55% 12.9% 2.8% 7.4% 26.2% 60% 12.2% 5.6% 2.5% 23.1% >60% 5.9% 0.0% 2.5% 10.8%

Extended/ Special Skills 3.3% 6.7% 23.3% 23.3% 33.3% 10.0%

Base: Respondents who were paid a percentage of billings

Furthermore, the majority of those who are paid a percentage of billings (83%) are on a weekly, fortnightly or monthly billing cycle, rather than the default 3 month cycle, which is a plus for these Registrars as this increases their earnings.

Table D: Frequency of Billing Cycle All Registrars Weekly Fortnightly Monthly Three Monthly

16.6% 55.5% 10.6% 17.4%

Base: Respondents who were paid a percentage of billings

On average full-time Registrars worked 9.0 sessions each week with there not being a significant difference between the number of sessions worked between males (9.2 sessions) and females (8.9 session).

When it comes to Registrars’ experiences with negotiating their employment conditions less than one in two Registrars (44%) actually engage in negotiation with their practices, although this changes significantly over time with a minority of Registrars negotiating in GPT1 (27.7%) and a majority negotiating in GPT3 (56.7%) & Extended Skills terms (64.9%), as illustrated in the table below.

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Table E: Negotiated Current Employment Contract Term Currently In All Extended Skills/ Registrars GPT1 GPT2 GPT3 Special Skills Yes 44.2% 27.7% 38.8% 56.7% 64.9%

Interestingly, there were no significant differences in the percentage of Registrars that had negotiated their conditions at the gender level or between full-time or part-time Registrars, however general pathway Registrars were more likely than rural Registrars to have negotiated their employment conditions (49% vs. 37% rural) In terms of how they found the negotiation process itself, amongst those Registrars who actually negotiated their current employment conditions, most (58%) found it difficult and only around four in ten (39%) felt confident in negotiating the conditions of the term with their employer. This is one area where gender differences were apparent with female Registrars considerably more likely to find the process either ‘somewhat’ or ‘very’ difficult as compared to male Registrars (64% vs. 45% males). Similarly, where most male Registrars felt confident in negotiating the conditions of their term (59%), just one in three female Registrars did so (29%).

Where Registrars did engage in negotiation with practices the most common conditions negotiated on were the percentage of billings paid, normal working hours and holiday leave. The following table illustrates which conditions Registrars were able to negotiate on.

Table F: Conditions Negotiated On Percentage of in-hour billings Normal working hours Holiday leave Percentage of after-hours work Unpaid leave Teaching time (e.g. teaching medical students) After hours Salary Study leave On call Sick leave Paid leave Pay cycle (e.g. weekly, fortnightly, monthly) Percentage of hospital work Access to SIP payments Access to PIP payments Maternity/Paternity leave Super

% 45.5% 40.3% 26.0% 18.8% 16.9% 16.9% 16.2% 14.9% 13.0% 12.3% 10.4% 9.7% 9.1% 8.4% 8.4% 8.4% 6.5% 5.8%

Base: Respondents who took part in negotiations for their GPT1 and GPT2 terms

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Overall it appears that many Registrars are poorly informed about their entitlements with around one in ten Registrars (11%) not aware of the NMTC document and only around half (55%) referring to the document when determining their employment arrangements.

There was significant confusion around what types of leave Registrars are entitled to with 27% of respondents unsure if they were able to take study leave, 46% unsure about maternity/paternity leave and 40% who didn’t know about carers leave.

The survey appears to indicate that breaches of the NMTC occur amongst employers of GP Registrars and is of great concern to GPRA. Specifically, there are some Registrars who are forced or encouraged to work as contractors during GPT1 and GPT2 by their RTP (2%), practice (8%) or their supervisor (5%) and that as high as 15% appear to see more than the maximum recommended 4 patients per hour. Also, many Registrars indicated not being able to take the mandatory sick leave (7%), annual leave (2%), and carers leave (16%) to which they are entitled and 21% do not have a signed paper contract with their current employer.

The survey results suggest that Registrars, as a whole, require greater assistance through the negotiation process. Only around one in five Registrars (20%) appear to receive assistance from their RTP in negotiating and when this is provided it is normally basic verbal advice (56%) and/or a contract template is provided (48%).

Registrars were asked if they would like to have a document such as the NMTC to be implemented for GPT3 Registrars. While overall responses indicated that there may be support with this (41.9%), significant numbers were unsure (28.6%) or did not agree (29.5%) and the support for this idea decreased as Registrars progressed through training with only around a third (35.5%) of GPT3 Registrars supporting this concept.

Table G: Would Like for there to be a NMTC Document for GPT3 – by Term Currently In Term Currently In All Registrars GPT1 GPT2 GPT3 Yes 41.9% 44.7% 47.6% 35.5% No 29.5% 25.5% 23.0% 41.9% Unsure 28.6% 29.8% 29.4% 22.6%

Registrars were also asked what sort of assistance they would find useful in the negotiating process in GPT3 and a few options other than a NMTC style document (outlined in table below) were thought to be potentially useful.

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Table H: Usefulness of Resources in Negotiating for GPT3 (Subsequent Term) Usefulness Very useful a) Negotiating guidelines manual 50.2% b) Minimum terms and conditions document 46.9% c) Workshop on negotiating 49.7% d) Recommended contract with guidelines 56.1%

Of some use 39.9% 38.3% 36.5% 34.9%

Finally, whilst not the focus of the survey, findings suggested a need for more targeted support of Registrars undertaking their GPT1 term with just 55% of Registrars feeling satisfied with their job overall compared with 73% of all respondents. This may in part be due to low levels of satisfaction with the terms and conditions of their employment (40%) and that so few are able to negotiate better terms. That one in three GPT1 Registrar is paid a fixed salary (33%) may be the source of some disgruntlement, so too the fact that around one in three (35%) who are paid a percentage, are paid according to a three monthly billing cycle.

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3. Key Areas to be Addressed The findings from GPRA’s 2010 Terms and Conditions Benchmarking Survey highlighted a number of areas that, from GPRA’s point of view, require targeted attention to ensure that Registrars enter employment conditions that are both legal and well supported: 1. Prior to the commencement of Term 1 Registrars should be aware of the NMTC document.

2. All Registrars should have a signed written contract for each term of employment.

3. All Registrars should be informed of the legal obligations of employers regarding leave, annual leave, carer’s leave and public holiday pay/conditions. These obligations should be more clearly outlined in the next version of the NMTC. 4. The types of leave a Registrar is entitled to take as part of their employment should be clearly stipulated on their written employment contract.

5. All Registrars should be paid a base salary or percentage of billings for ordinary hours worked; no Registrar should be on a fixed salary, except those working as a salaried medical officer, e.g. in an Aboriginal Medical Service.

6. All Registrars should be employed as employees throughout the course of their training. In cases where a medical practice intends to employ a Registrar as a contractor, the medical practice or Registrar should be required to submit a written case outlining their reasons to the Registrar’s RTP. 7. All medical practices should be aware of the NMTC document and all practice managers should understand this document.

8. All Registrars who are paid as a percentage of billings should be paid on at least a monthly cycle, if not more frequently.

9. All Registrars should have access to necessary tools and resources to competently negotiate the terms and conditions of their employment. This can be facilitated by further GPRA workshops and resource development.

10. As almost 40% of GPT2 Registrars are paid above 45%, consideration should be made to increasing the percentage in the NMTC for those Registrars who are performing well.

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4. Limitations of the Research As described in the research methodology, questions were not made compulsory to answer in the online survey capture tool. Whilst this gave respondents the freedom to only answer the questions they wanted to, this led to many non-responses on important measures. For example, as high as 30% of respondents did not respond to the measure on what their average gross weekly earnings were from working in the training program (Q18) and 30% did not indicate how many sessions they worked per week (Q19). Although substantial bases were received for these measures (301 and 295 respectively once outliers were removed) the high proportion of non-responses suggest that the results for these measures should only be treated as indicative and not entirely representative of Registrars views/circumstances; these non-responses also led to insufficient bases at the segment level for some categories (e.g. for part-time male Registrars) to enable reliable comparisons. It should also be noted that many Registrars responding to the survey may not have actually known how much they earn (i.e. regarding Q18 average gross weekly earnings) and thus were not able to respond to this question.

A higher response rate would also need to be sought in future to enable reliable comparisons at the segment level for other measures. Most particularly if comparisons are to be sought at the RTP and/or location level and for more robust sample sizes by the term Registrars are currently in. GPRA could perhaps enlist the support of RTPs in getting more Registrars to respond in future.

In terms of the issues the survey covers, it would be interesting for future waves of the survey to include measures which lend insight into whether Registrars are offered the opportunity to negotiate the terms of their employment. More information around how Registrars are employed as contractors, (i.e. the circumstances around this), would also be interesting to canvass. It would also be interesting to hear the view of RTPs and of employing practices with regards to the various issues involved in Registrars negotiating their terms of employment. In particular, the role RTPs see themselves as playing in their support to Registrars during the negotiation process. This would enable, perhaps a more complete picture of what occurs across the sector and could perhaps be addressed in a separate exercise to the Terms and Conditions survey.

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There was also a limitation with regards to the results obtained from the average gross weekly earnings measure (Q18) which means that these results, and their derivative results (i.e. per session earning average) can only be treated as indicative. Respondents were asked “What are your average gross weekly earnings from work within the training program including after hours and on call?”; earnings per session figures provided in this report thus include after hours and on call work; given that earnings from working after hours and/or on call can vary significantly between Registrars there may be less accurate results for gross weekly earnings and per session earnings and it should be noted that these averages are likely to be higher than someone who does not participate in overtime or on call activities.

GPRA sought to clarify these issues with the data in a separate survey which was conducted in May 2010 (‘GPRA’s Training Time Survey’). This survey asked Registrars to estimate how much they earned for ordinary hours in General Practice exclusive of overtime and on call.

The results from this survey can be viewed in Appendix A and show that average weekly earnings were fairly consistent across the two surveys, when comparing earnings for full-time and part-time Registrars and by term currently in.

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5. Survey Methodology The survey was conducted online and carried out by GPRA. The survey was open to all GP Registrars in Australia.

GPRA invited all Registrar Liaison Officers (RLOs) to complete the survey via an email invitation containing a link to the survey. RLOs were also asked to forward the survey link to all Registrars within their Regional Training Provider (RTP). Following the initial email broadcast, GPRA encouraged completion of the survey by issuing two reminder emails and conducting follow-ups via the GPRA Advisory Council Mailing List. The survey was also promoted via the monthly GPRA eNewsletter.

The survey period ran from Thursday 29 October 2009 to Monday 4 January 2010 which allowed ample time for Registrars to take part in the survey.

RLOs and Registrars were invited to complete the Terms and Conditions Survey with the premise that GPRA would like to attain an overview of how Registrars are currently being remunerated, given the numerous changes taking place with the training program, along with the relevant federal changes. Registrars were also informed that the survey results would better enable GPRA to evaluate and start negotiating for the NMTC for the next two years and to be in a stronger position to negotiate salaries on Registrars’ behalf.

The survey instrument was developed by GPRA and covered the following broad topic areas (see Appendix B for survey questionnaire): • • • • • • • • •

Demographic details Employment conditions Work outside of the GP training program Billing profile and earning capacity Negotiating terms of employment Preference for a NMTC document for GPT3 Compliance with current NMTC for GPT1 and GPT2 Educational release time Sick leave, annual leave, public holidays and other leave

A total 435 GP Registrars completed the survey. The time to complete the survey is approximately 10 minutes. Questions were not made compulsory to answer so as to not make the questionnaire too onerous to complete but also because of the sensitive/personal nature of some of the questions. Where not all respondents answered the question, this is noted at the bottom of result charts and tables.

Not applicable responses were removed from percentages. A demographic profile of the Registrars who responded is provided in Section 6.

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The results are reported at the total level (i.e. based on all respondents who answered the question) and are also shown or commented on if there were differences at the segment level at the 95% confidence interval. Segment analysis was carried out for gender (male, female), training pathway (general, rural), training term currently in (GPT1, GPT2, GTP3, other) and training workload (full-time, part-time). Too few responses were received by Academic Post (n=4) for results to be reported for this segment.

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6. Demographic Profile of Respondents GP Registrars from every RTP in Australia were represented in the survey (see Table 1).

More than ten responses were achieved for every RTP, with the exception of RVTS, QRME (formerly RRQC) and WentWest. The highest proportion of responses were received from Registrars from VMA in Victoria (12%) followed by those from CSQTC in Queensland (11%).

Table 1: Regional Training Provider Regional Training Provider Adelaide to Outback General Practice Training Program (AOGP) Bogong Regional Training Network (Bogong) Central & Southern Queensland Training Consortium (CSQTC) CoastCityCountry Training (CCCT) General Practice Training Tasmania (GPTT) General Practice Training Valley to Coast (GPTVTC) Gippsland Education & Training for General Practice (getGP) GP Synergy GPlogic Greater Green Triangle General Practice Training & Education (GGT) Institute of General Practice Education (IGPE) North Coast GP Training (NCGPT) Northern Territory General Practice Education (NTGPE) Queensland Rural Medical Education (QRME) (formerly, and at the time of the survey, Rural & Regional Queensland Consortium (RRQC) Remote Vocational Training Scheme (RVTS) Sturt Fleurieu General Practice Education & Training Tropical Medical Training (TMT) Victoria Felix Medical Education (VFME) Victorian Metropolitan Alliance (VMA) WentWest Western Australian General Practice Education & Training (WAGPET)

%

n

5.4 3.5

23 15

10.5 7.3 6.1 5.9

45 31 26 25

3.3 4.7 2.6

14 20 11

2.6 5.4 3.5 5.4

11 23 15 23

0.2 0.2 2.8 4.9 8.9 11.9 1.9

1 1 12 12 38 51 8

3.0

13

Base: All Respondents (n= 427; 8 respondents did not provide a response)

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Consistent with the AGPT program enrolment figures, around two-thirds of the survey respondents (59%) were enrolled in the general pathway and the remaining in the rural pathway. Most respondents (77%) were undertaking their training full-time and the vast majority were training towards fellowship of the RACGP (95%). Registrars at various stages in the training program responded to the survey, with GPT2 term Registrars being the most highly represented (40%) (see Table 2).

Table 2: Current Training Training Pathway General Rural Training Workload Full-time Part-time Term Currently In GPT1 GPT2 GPT3 Extended skills/Special skills ARSP Academic Post Other (see below) Endpoints Training Towards FRACGP FACRRM FARGP Other (‘have FRACGP’)

% 59.2 40.8 % 77.2 22.8 % 20.7 40.1 19.6 13.3 5.4 1.0

n 255 176 n 332 98 n 81 157 77 52 21 4 45

94.9 7.2 10.4 0.2

411 31 45 1

Base: All Respondents. Note: the following number of respondents did not provide a response for, ‘training pathway’, n=4; ‘training workload’, n=5; ‘term currently in’, n=43 and ‘endpoints training towards’, n=2.

The ‘other’ responses for Q.6, Term Currently In (n=45), were as follows: • Hospital term – 18 responses • Commencing GPT1 in 2010 – 4 responses • Maternity leave – 3 responses • Academic post as well – 2 responses • Extension, awaiting fellowship – 2 responses • Subsequent term – 2 responses The following were individual responses at Q.6 ‘other’; 2nd hospital year, awarded RPL for all 4 years of ACRRM training, both Academic Post and Extended Skills P/T each, currently not working taking 6 months off, extension, FRACGP newly qualified, GP 1.2, GPT3 & ARSP, GPT4, HMO2, mandatory elective, special skills in public hospital, subsequent 2, I finished Feb 2009 but am filling out this survey because I received it and think it is important.

Two thirds of the respondents were female (66%), which is also reflective of the number of females enrolled in the AGPT program, and most respondents (65%) were aged 26 to 35 years.

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Table 3: Personal Details Gender Male Female Age Group 20 – 25 26 – 30 31 – 35 36 – 40 41 – 45 46 – 50 Over 50

% 34.3 65.7

n 147 282

1.6 37.6 27.6 10.4 10.7 6.3 5.8

7 162 119 45 46 27 25

Base: All Respondents. Note: n=4 did not provide a response for ‘age’ and 6 for ‘gender’.

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7. Detailed Findings 7.1 Employment Conditions: Arrangement Registrars Have with their Employers Basic awareness of the National Minimum Terms and Conditions document for GPT1 and GPT2 Registrars (NMTC) was ascertained as well as under what conditions respondents were employed under.

The results suggest that around one in every ten GP Registrar (11%) is not aware that the NMTC document exists; it should be noted that the total sample included 18 respondents who were in hospital term and would thus not have had to refer to the document as yet.

Looking at the responses by the term respondents were currently in, there indeed appears to be a small proportion of Registrars across all terms not aware of the document (14%, 7% and 8% across GPT1, GPT2 and GPT3 Registrars respectively).

Further, the results suggest that only around half of Registrars (55%) refer to the NMTC document when determining their employment arrangements with their employer; it could be suggested that this in itself would set the scene for non-compliance in some cases.

Interestingly, female as compared to male Registrars were more likely to refer to the document (59% vs. 47% male); this result could perhaps be explained by the fact that there were more than twice as many female part-time Registrars as there were male part-time Registrars in the sample (28% vs. 12% male) and the fact that it is more complex to work parttime; a part-time Registrar would be more likely to consult the NMTC document to work out what their employment arrangements should be.

Of particular concern is the survey result that suggests that around one in every five Registrars does not have a written contract regarding their employment with their current employer (21%), with part-time Registrars particularly likely not to have one (29% vs. 19% fulltime Registrars, approaches significance). Further almost one in ten Registrars (9%) are employed as a contractor as opposed to as an employee which, as far as GPRA are aware should be the case (with the exception of some GPT3 Registrars in special circumstances); a further 5% are employed as both an employee and as a contractor.

Once the next NMTC document is finalized, GPRA will be working to ensure that all Registrars are aware of the document prior to engaging in employment negotiations with their (next) employer. GPRA would also like to have all Registrars have a signed written contract for each term of employment.

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As high as 7% of respondents indicated not being aware as to what conditions they were employed under; this was highest amongst GPT1 Registrars (12%) (see Table 5).

Table 4: Employment Conditions Aware of the NMTC Document for GPT1 (basic) and GPT2 (advanced) Registrars Yes No Had Signed Paper Contract with Current Employer Yes No Referred to NMTC Document When Determining Employment Arrangements Yes No Condition Employed As Employee Contractor Both (working at more than 1 location) Unsure Other

%

n

89.5 10.5

357 42

78.6 21.4

312 85

55.2 44.8

216 175

78.5 9.1 5.1 7.3

310 36 20 29 7

Q8. Are you aware of the National Minimum Terms & Conditions document for GPT1 (basic) and GPT2 (advanced) Registrars? Base: All Respondents (n=399; n=36 did not answer this question) Q9. Do you have a signed paper contract with your current employer? Base: All Respondents (n=397; n=38 did not answer this question) Q10. Did you refer to the NMTC document when determining your employment arrangements? Base: All Respondents (n=391; n=44 did not answer this question) Q11. Are you employed as a(n)? Base: All Respondents (n=395; n=40 did not answer this question)

Table 5 presents the results for the conditions respondents are employed under by the training term they are currently in. These indicate that Registrars employed as Contractors are most likely to be in GPT3 (26%, employed as contractors or as contractors and employees). When the results are broken down by RTP, it is noteworthy that more than10% of the respondents from three RTPs indicated being employed as contractors; this may suggest that these RTPs may have a particular arrangement that allows them/their medical practices to employee Registrars as contractors.

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Whether Registrars should be employed as employees or contractors, at various stages of training, has been an area of ongoing confusion for GPRA. GPRA are of the general understanding that all GPT1 and GPT2 Registrars must be employed as employees and not contractors and that under special circumstances GPT3 Registrars may be employed as contractors. It is however not clear under what circumstances or conditions a Registrar would be employed as a contractor.

GPRA are of the view that a Registrar should be employed as an employee throughout the course of their training. A Registrar is essentially a trainee or an apprentice in a training program and should therefore not be working in an independent capacity in working towards meeting their training requirements. If a Registrar wishes to pursue being a contractor, GPRA will be recommending that they seek independent advice.

Table 5: Conditions Employed As - by Term Currently In Term Currently In Extended skills/Special Condition Employed As GPT1 GPT2 GPT3 skills 75.8% 89.3% 73.0% 71.7% Employee (50) (133) (54) (33) Contractor 6.1% 1.3% 23.0% 13.0% (4) (2) (17) (6) Both (working at more 6.1% 4.7% 2.7% 10.9% than 1 location) (4) (7) (2) (5) Unsure 12.1% 4.7% 1.4% 4.3% (8) (7) (1) (2) Other (please specify) 1 1 2 2 answered question 66 149 Q11. Are you employed as a(n)?

Base: All Respondents (n=32 did not answer this question)

74

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ARSP

90.5% (19) 0.0% (0) 4.8% (1) 4.8% (1) 0 21

Total 78.5% (310) 9.1% (36) 5.1% (20) 7.3% (29) 395

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Table 6: Benefits Received In Addition to Salary Benefits a) Rental subsidy b) Accommodation assistance c) Travel reimbursements d) Salary packaging options e) Not sure Other

Yes 14.4% (52) 17.1% (61) 10.9% (39) 21.4% (77) 15.3% (19)

No 85.6% (309) 82.9% (296) 89.1% (318) 78.6% (283) 84.7% (105)

Response Count 361 357 357 360 124 24

Q15. Which of the following benefits does your employer offer you, in addition to your salary?

Base: All Respondents (n=44 did not answer this question)

Apart from their salary, the majority of Registrars are not offered any additional benefits from their employer (see Table 6). The most popular benefit offered to Registrars are salary packaging options (21%) which are available to most individuals working in the health industry.

As would be expected rural pathway Registrars were significantly more likely to be offered certain benefits than were general pathway Registrars, namely, rental subsidy (28% vs. 6% general), accommodation assistance (35% vs. 5% general) and travel reimbursements (19% vs. 6% general). They were also more likely to be offered salary packaging options (27% vs.

18% general, approaches significance).

There were also some differences with regards to the benefits Registrars are offered by term they were in which is perhaps more surprising. Most notable is that GPT3 Registrars were less likely than the average to be offered salary packaging options (8% GPT3 Registrars vs. 21% total).

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7.2 Billing Profile and Earning Capacity Respondents were asked a series of questions in order to benchmark what the average Registrar currently earns and how their pay is structured.

This section presents results for the following: • Registrar autonomy in choosing how patients are billed • Registrar billing profile • Weekly earnings, sessions worked & per session earning average • Registrar remuneration structure • After hours and/or on-call work 7.2.1 Autonomy in Choosing How Patients are Billed Chart 1: Autonomy to Choose How Patients are Billed

Q16. Do you have autonomy to choose how your patients are billed? i.e. private or bulk bill? All Respondents (n=318; n=117 rdid not answer this question)

The majority of Registrars appear to have some autonomy with regards to how they bill their patients (69% Always/Almost always/Within broad guidelines), with rural Registrars more likely to have a say than general Registrars (75% vs. 65% general, approaches significance), and GPT1 Registrars less likely than GPT2 and GPT3 Registrars (57% vs. 75% GPT2 and 78% GPT3).

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Some respondents provided additional comments at this question which lent some insight into these results; these are provided below.

Additional comments made at Q.16, Autonomy to Choose How Patients are Billed, were as follows (n=40): • NA/Not yet started work as a GP Registrar - 12 responses o E.g., Not sure not at that point yet • Work in bulk billing practice/All patients are bulk billed – 11 responses o E.g., All are bulk-billed - happy with this • Different arrangement/Other - 4 responses o E.g.; Reception changes bills • Work in Aboriginal Medical Service (AMS) - 4 responses • Some patients always bulk billed but have choice with other patients - 4 responses o E.g., Many patients have been at the practice for many years and some have an arrangement whereby they are bulk-billed even though we are supposed to be a privately billing practice … So if someone is already bulk-billed I can't then charge them privately, but if someone usually pays privately I can bulk-bill them if I choose • NA/Currently in ARSP - 3 responses o E.g., Not applicable, do not attract Medicare in ARSP • Not allowed to private bill - 2 response o E.g., I can choose to bulk bill but I cannot privately bill against practice guidelines

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7.2.2 Registrar Billing Profile Table 7: Estimated Billing Profile Percentage of Billing Profile Billing Type Percentage that is Bulk Billed Percentage that is Private billed Percentage of Workcover billings Other Miscellaneous billings

5% or less 4.9% (15) 14.5% (40) 72.2% (190) 86.2% (150)

10-30% 22.3% (68) 32.7% (90) 26.2% (69) 12.1% (21)

40-60% 32.5% (99) 34.9% (96)

70-90% 27.5% (84) 16.4% (45)

1.5% (4)

0.0% (0)

0.0% (0)

0.0% (0)

100% 12.8% (39) 1.5% (4) 0.0% (0) 1.7% (3)

Total Responses 305 275 263 174

Q17. Please provide an estimate of your billing profile (total must add to 100). Base: All Respondents (n=310; n=125 did not answer this question)

Respondents were asked to estimate what proportion of their billings was made up of bulk billings, private billings, Workcover billings, as well as any other miscellaneous billings. The results, as shown in Table 7, indicate that how Registrars bill varies to a fair degree across Australia, although for around a third of Registrars (33%) bulk billing makes 40-60% of their billing profile. Private billing also makes up a similar proportion of their billings for Registrars (35%), whilst the majority do very little Workcover or other miscellaneous billings.

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7.2.3 Weekly Earnings, Sessions Worked & Per Session Earning Average Respondents were asked to first provide an estimate of their average gross weekly earnings from their work within the training program, followed by the average number of sessions they work within a week. Using these results, a per session earning average for Australian GP Registrars was derived ($274). It should be noted that all gross weekly earnings results and per session earning average results presented in this section should be treated as indicative only; respondents were asked to provide their gross weekly earnings including after hours and on-call work; as after hours and on-call can vary considerably between Registrars, accurate weekly earnings and per session earning averages may not have been captured.

Tables 8 and 9 present the average gross weekly earnings for Registrars by training workload and gender, as well as by training workload and training pathway. Per session earning averages for these same demographics are presented in Tables 12 and 13.

Whilst there does not appear to be any significant differences in earnings between rural and general pathway Registrars, at either the full-time or part-time breaks (see Tables 9 and 13), differences are apparent between the earnings of male and female Registrars.

Without taking into consideration number of sessions worked, male Registrars appear to earn significantly more than do female Registrars per week, across both full-time and part-time (see Table 8; part-time result should be treated as indicative only due to small sample size for male part-time Registrars); the difference between the genders is also apparent when the average number of sessions worked per week is taken into consideration (see Table 12 for per session earning averages). For further insight into earning average differences between male and female Registrars see the discussion on after hours an on-call work in section 7.2.4 Registrar Remuneration Structure.

Average gross weekly earnings, average number of sessions worked per week and per session earning averages by GP term are provided in Tables 14 to 16 respectively. Table 16 illustrates that earning capacity appears to increase the further into training a Registrar is ($249, $259 and $332 for GPT1, GPT2 and GPT3 Registrars respectively).

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Table 8: Average Gross Weekly Earnings - by Training Workload & Gender Total Full-Time Part-Time Total Males Females Total Males Average $2,192 $2,434 $2,645 $2,311 $1,551 $2,115** Maximum $6,000 $6,000 $6,000 $6,000 $5,000 $5,000 Minimum $200 $960 $960 $960 $200 $600

Females $1,455 $4,000 $200

Standard $1,147 $1,135 $1,174 $1,101 $919 $1,295 $793 Deviation No. of 301 219 79 138 80 13* 66 Responses Q18. What are your average gross weekly earnings from work within the training program including after hours and on call? Base: All Respondents (n=301; n=129 did not answer this question and n=5 outliers were removed) *Note: Small Sample Size (n=<30), interpret with caution. Figures highlighted in bold are statistically significantly different at the 95% confidence interval. **Note: significant difference should be treated as indicative only due to small sample size

Table 9: Average Gross Weekly Earnings - by Training Workload & Training Pathway Total Full-Time Part-Time Total General Rural Total General Average $2,192 $2,434 $2,453 $2,427 $1,551 $1,559 Maximum $6,000 $6,000 $6,000 $6,000 $5,000 $3,500 Minimum $200 $960 $960 $960 $200 $350

Rural $1,524 $5,000 $200

Standard $1,147 $1,135 $1,143 $1,139 $919 $822 $1,225 Deviation No. of 301 219 112 105 80 62 18* Responses Q18. What are your average gross weekly earnings from work within the training program including after hours and on call? Base: All Respondents (n=301; n=129 did not answer this question and n=5 outliers were removed) *Note: Small Sample Size (n=<30), interpret with caution.

Table 10: Average Number of Sessions Worked per Week within AGPT - by Training Workload & Gender Total Full-Time Part-Time Total Males Females Total Males Females Average 8.0 9.0 9.2 8.9 5.3 6.0 5.2 Maximum 14 14 14 11 10 10 9 Minimum 3 7 7 7 3 4 3 Standard 2.0 0.9 1.1 0.8 1.6 1.6 1.6 Deviation No. of 295 211 74 135 82 15* 66 Responses Q19. How many sessions from work within the training program (one session is typically 3-4 hrs) per week do you do on average? Base: All Respondents (n=295; n=129 did not answer this question and n=11 outliers were removed) *Note: Small Sample Size (n=<30), interpret with caution.

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Table 11: Average Number of Sessions Worked per Week within AGPT - by Training Workload & Training Pathway Total Full-Time Part-Time Total General Rural Total General Rural Average 8.0 9.0 8.9 9.2 5.3 5.3 5.4 Maximum 14 14 12 14 10 10 9 Minimum 3 7 7 7 3 3 3 Standard 2.0 0.9 0.9 1.0 1.6 1.6 1.6 Deviation No. of 295 211 110 100 82 64 18* Responses Q19. How many sessions from work within the training program (one session is typically 3-4 hrs) per week do you do on average? Base: All Respondents (n=295; n=129 did not answer this question and n=11 outliers were removed) *Note: Small Sample Size (n=<30), interpret with caution.

Table 12: Per Session Earning Average – by Training Workload & Gender Total Full-Time Part-Time Total Males Females Total Males Average $274 $270.4 $287.5 $259.7 $292.6 $352.5** Maximum $428.6 $428.6 $428.6 $545.5 $500 $500 Minimum $66.7 $137.1 $137.1 $137.1 $66.7 $150

Females $279.8 $444.4 $66.7

No. of 295 211 74 135 80 13* 66 Responses Q18. What are your average gross weekly earnings from work within the training program including after hours and on call? & Q19. How many sessions from work within the training program (one session is typically 3-4 hrs) per week do you do on average? *Note: Small Sample Size (n=<30), interpret with caution. **Note: significant difference should be treated as indicative only due to small sample size

Table 13: Per Session Earning Average - by Training Workload & Training Pathway Total Full-Time Part-Time Total General Rural Total General Average $274 $270.4 $275.6 $263.8 $292.6 $294.2 Maximum $428.6 $428.6 $500 $428.6 $500 $350 Minimum $66.7 $137.1 $137.1 $137.1 $66.7 $116.7

Rural $282.2 $555.6 $66.7

No. of 295 211 110 100 80 62 18* Responses Q18. What are your average gross weekly earnings from work within the training program including after hours and on call? & Q19. How many sessions from work within the training program (one session is typically 3-4 hrs) per week do you do on average? *Note: Small Sample Size (n=<30), interpret with caution.

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Table 14: Average Gross Weekly Earnings - by GP Term Currently In GP Term Total Extended Skills/ GPT1 GPT2 GPT3 Special Skills Average $2,192 $1,914 $2,148 $2,354 $2,573 Maximum $6,000 $5,000 $6,000 $6,000 $6,000 Minimum $200 $250 $200 $540 $900 $1,147 $1,156 $1,076 $1,264 $1,311 Standard Deviation

ARSP $2,007 $5,000 $1,200 $839

No. of 301 41 123 66 38 17* Responses Q18. What are your average gross weekly earnings from work within training program including after hours and on call? Base: All Respondents (n=301; n=129 did not answer this question and n=5 outliers were removed) *Note: Small Sample Size (n=<30), interpret with caution.

Table 15: Average Number of Sessions Worked per Week within AGPT - by GP Term Currently In GP Term Total Extended Skills/ GPT1 GPT2 GPT3 Special Skills ARSP Average 8.0 7.7 8.3 7.1 7.9 9.2 Maximum 14 10 14 10 11 11 Minimum 3 3 3 3 3 5 2.0 2.1 1.8 2.2 2.0 1.5 Standard Deviation No. of 295 35 122 67 39 15* Responses Q19. How many sessions from work within the training program (one session is typically 3-4 hrs) per week do you do on average? Base: All Respondents (n=295; n=129 did not answer this question and n=11 outliers were removed) *Note: Small Sample Size (n=<30), interpret with caution.

Table 16: Per Session Earning Average – by GP Term Currently In GP Term Total Extended Skills/ GPT1 GPT2 GPT3 Special Skills Average $274 $248.6 $258.8 $331.5 $325.7 Maximum $428.6 $500 $428.6 $600 $545.5 Minimum $66.7 $83.3 $66.7 $180 $300

ARSP $218.2 $454.5 $240

No. of 295 35 122 66 38 15* Responses Q18. What are your average gross weekly earnings from work within training program including after hours and on call? & Q19. How many sessions from work within the training program (one session is typically 3-4 hrs) per week do you do on average? *Note: Small Sample Size (n=<30), interpret with caution.

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7.2.4 Registrar Remuneration Structure

Chart 2: Registrar Remuneration Structure - by Term Currently In

Q20. For ordinary hours of work, I am paid… Base: All Respondents (n=331; n=104 did not answer this question) *Note: Small Sample Size (n=<30), interpret with caution.

Registrars are entitled to the greater of 45% of gross ordinary hours billings, or the base rate plus 9% superannuation. As shown in Chart 2, just under half (46%) are remunerated under this structure, with GPT1 (51%) and GPT2 Registrars (64%) being particularly likely to have this arrangement. Conversely, GPT3 Registrars and those undertaking extended or special skills training are more likely to be getting a percentage of billings (56% and 51% respectively).

The survey findings suggest that as high as one in three GPT1 Registrars (33%) are being paid a fixed salary and thus around one in three medical practices must be employing basic term Registrars outside the scope of the NMTCs. Further, the fact that the GPT1 Registrar respondents who were on a fixed salary came from 9 different RTPs suggests that this practice is fairly wide spread.

Whilst GPRA will work to ensure that all new Registrars are aware of the new NMTC and that each Registrar has a signed written contract before commencing work with a medical practice, compliance with the NMTCs also needs to be enforced at the medical practice level by RTPs. This could involve ensuring Practice Managers understand the new NMTC document.

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Chart 3: Base Salary as Compared to NMTC

Q21. If you are paid a base salary, is this salary … Base: Those respondents who were aware of the NMTC (at Q8) and who were paid a base salary (n=166)

Removing the responses of those unaware of the NMTC, the majority of those who were paid a base salary, were of the understand that their salary equals the National Minimum Terms & Conditions (73%), whilst around one in five knew that they were getting a better deal than the minimum (21%).

Chart 4: Percentage of Billings are Paid

58% of Respondents who are paid a percentage of billings, are paid more than the minimum

Q22. If you are paid a percentage, what is the percentage? Base: Those respondents who were paid a percentage of billings (at Q20)(n=271)

Amongst those Registrars who are paid a percentage of billings, whilst around four in every ten receive the minimum required (42%, see Chart 4), a greater proportion, 58%, have actually been able to negotiate for more.

Drilling down to the segment level, it’s apparent that Registrars with a part-time training workload are particularly likely to be getting a percentage greater than the minimum; 69% of part-time Registrars receive 50% or more, compared to 54% of full-time Registrars (Table 17).

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With regards to the term respondents are currently in, not surprisingly, GPT1 and GPT2 Registrars are the most likely to be receiving a 45% of billings (72% and 61% respectively), whilst GPT3 Registrars and those undertaking extended and/or special skills training are particularly likely to be receiving 45% or more (86% and 97% respectively) (Table 18); that one GPT3 Registrar is only getting 40% of billings, which lies outside the NMTCs, is of note.

Table 17: Percentage of Billings are Paid – by Gender, Training Workload & Training Pathway Total Gender Training Workload Training Pathway Male Female Full-Time Part-Time General Rural 0.7% 1.2% 0.5% 0.5% 1.4% 0.0% 1.9% 40% (2) (1) (1) (1) (1) (0) (2) 41.7% 38.8% 42.3% 46.0% 30.0% 41.7% 41.1% 45% (113) (33) (77) (92) (21) (68) (44) 50% 26.6% 27.1% 26.4% 27.0% 25.7% 30.1% 21.5% (72) (23) (48) (54) (18) (49) (23) 17.8% 55% 12.9% 9.4% 14.8% 10.5% 18.6% 9.8% (16) (19) (35) (8) (27) (21) (13) 60% 12.2% 15.3% 11.0% 11.0% 15.7% 12.3% 12.1% (33) (13) (20) (22) (11) (20) (13) 4.9% 5.0% 8.6% 6.1% 5.6% More than 5.9% 8.2% (7) (9) (10) (6) (10) (6) 60% (16) No. of 271 85 182 200 70 163 107 Responses Q22. If you are paid a percentage, what is the percentage? Base: Those respondents who were paid a percentage of billings (at Q20)

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Table 18: Percentage of Billings are Paid – by Term Currently In Total Term Currently In Extended/ GPT1 GPT2 GPT3 Special Skills 0.7% 0.0% 0.0% 1.5% 3.3% 40% (2) (0) (0) (1) (1) 45% 41.7% 72.2% 60.7% 12.3% 6.7% (113) (26) (74) (8) (2) 50% 26.6% 19.4% 27.0% 26.2% 23.3% (72) (7) (33) (17) (7) 55% 12.9% 2.8% 7.4% 26.2% 23.3% (35) (1) (9) (17) (7) 60% 12.2% 5.6% 2.5% 23.1% 33.3% (33) (2) (3) (15) (10) More than 5.9% 0.0% 2.5% 10.8% 10.0% 60% (16) (0) (3) (7) (3)

ARSP 0.0% (0) 16.7% (1) 50.0% (3) 16.7% (1) 0.0% (0) 16.7% (1)

No. of 271 36 122 65 30 6* Responses Q22. If you are paid a percentage, what is the percentage? Base: Those respondents who were paid a percentage of billings (at Q20) *Note: Small Sample Size (n=<30), interpret with caution

Chart 5: Frequency of Billing Cycle

Q23. If applicable (at 22), is the percentage calculated … Base: Those respondents who were paid a percentage of billings (at Q20) (n=265)

Amongst those Registrars who are paid a percentage of billings, most (83%) are on a weekly, fortnightly or monthly billing cycle. Whilst this is a good result, almost one in five Registrars who are paid a percentage (17%) are financially disadvantaged by being on a threemonthly billing cycle.

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GPRA would like to see all Registrars who are paid a percentage of billings to be on either a weekly, fortnightly or monthly billing cycle and no less frequent than this.

Some additional comments were made at ‘other (please specify)’at Q23 (n=12) which lent some further insight: • Daily, n=3 • Not sure, n=2 • The following were individual mentions; I get 100% of billings then pay back 40% in service fee, Varies - approximately 2nd-monthly, 6-weekly, Calculated 3-monthly in first 6months of the training, On a per-session basis, Not paid until 6/12 after leaving place of employment, and Used to be three monthly until I threatened to leave.

More experienced GP Registrars tend to have more frequent billing cycles. While GPT1 Registrars are the more likely than other Registrars to be paid on a three-monthly basis (see Table 19), GPT3 Registrars (87%) are more likely to be paid on a weekly or fortnightly basis.

This could indicate that as Registrars move through the training program, they become better able to negotiate better deals for themselves, or are better taken care of by their practices. That as high as one in three GPT1 Registrars are on a three-monthly billing cycle is noteworthy.

Table 19: Frequency of Billing Cycle – by Term Currently In Total Term Currently In Extended/ GPT1 GPT2 GPT3 Special Skills 16.6% 10.8% 13.4% 22.2% 27.6% Weekly (44) (4) (16) (14) (8) Fortnightly 55.5% 43.2% 52.1% 65.1% 58.6% (147) (16) (62) (41) (17) Monthly 10.6% 10.8% 14.3% 6.3% 6.9% (28) (4) (17) (4) (2) Three 17.4% 35.1% 20.2% 6.3% 6.9% Monthly (46) (13) (24) (4) (2)

ARSP 14.3% (1) 71.4% (5) 14.3% (1)

No. of 265 37 119 63 29* 7* Responses Q23. If applicable, is the percentage calculated … Base: Those respondents who were paid a percentage of billings (at Q20) *Note: Small Sample Size (n=<30), interpret with caution

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Chart 6: After Hours and On-Call Work

Q24. Do you do after hours or on-call work? Base: All Respondents (n=332; n=103 respondents did not answer this question).

Just over half of all respondents (59%) indicated that they do some after hours or on-call work, that is, as stipulated in the NMTC, work that’s in excess of the 38hours working week averaged over a four week cycle.

The results revealed a number of significant differences at the segment level, with male Registrars (67% vs. 55% female), full-time Registrars (66% vs. 39% part-time) and those undertaking their GPT2 term or Extended/Special skills training (64% and 66% respectively) being the more likely to be doing after hours or on-call work (see Tables 20 and 21).

As expected, the most striking difference is the proportion of rural pathway Registrars who currently do after hours/on-call work as compared to general pathway Registrars; around four in every five (82%) compared to around four in every ten (43%).

The number of male Registrars undertaking after hours or on-call work goes some way to explaining why the per session earning average amongst male Registrars appears to be marginally greater than that for female Registrars (see Table 12) - as after hours/on call work attracts (should attract) a higher percentage of gross billings (i.e. minimum of 55%).

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Table 20: After Hours/On-Call Work – by Gender, Training Workload & Training Pathway Total Gender Training Workload Training Pathway Male Female Full-Time Part-Time General Rural 58.7% 66.7% 55.0% 65.9% 39.3% 42.8% 81.8% Yes (195) (72) (121) (162) (33) (83) (112) No 41.3% 33.3% 45.0% 34.1% 60.7% 57.2% 18.2% (137) (36) (99) (84) (51) (111) (25) No. of 332 108 220 246 84 194 137 Responses Q24. Do you do after hours or on-call work? Base: All Respondents (n=103 respondents did not answer this question).

Table 21: After Hours/On-Call Work – by Term Currently In Total Term Currently In Extended/ GPT1 GPT2 GPT3 Special Skills 58.7% 51.0% 63.6% 47.1% 65.9% Yes (195) (25) (84) (33) (27) No 41.3% 49.0% 36.4% 52.9% 34.1% (137) (24) (48) (37) (14)

ARSP 72.2% (13) 27.8% (5)

No. of 332 49 132 70 41 18* Responses Q24. Do you do after hours or on-call work? Base: All Respondents (n=103 respondents did not answer this question). *Note: Small Sample Size (n=<30), interpret with caution.

Chart 7: After Hours/On-Call Work Payment Structure

Q25. For after hours or on-call work, I am paid… Base: Those respondents who indicated that they do after hours or on-call work (n=185)

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Respondents who do some after hours or on-call work are typically paid a percentage of billings for this work (64%, see Chart 7). This is also the case across the various demographic segments, although GPT3 Registrars (81%) and rural Registrars (72%) are particularly likely to be paid a percentage of billings for the after hours/on-call work they do (see Table 22). It is good to see that most rural Registrars are paid a percentage of billings for this work, given the number of after hours/on-call hours they do/are required to do (see Table 23).

Table 22: After Hours/On-Call Work Payment Structure – by Training Pathway & Term Currently In Total Term Currently In Training Pathway Ext/ Spec GPT1 GPT2 GPT3 Skills ARSP General Rural 18.9% 13.6% 14.8% 9.4% 11.5% 66.7% 17.7% 19.8% Fixed Salary (35) (3) (12) (3) (3) (8) (14) (21) Percentage 64.3% 63.6% 61.7% 81.3% 80.8% 33.3% 54.4% 71.7% (119) (14) (50) (26) (21) (4) (43) (76) Base salary or 16.8% 22.7% 23.5% 9.4% 7.7% 0.0% 27.8% 8.5% (9) % of billings, (31) (5) (19) (3) (2) (0) (22) whichever is greater No. of 185 22* 81 32 26* 12 79 106 Responses Q25. For after hours or on-call work, I am paid… Base: Those respondents who indicated that they do after hours or on-call work. *Note: Small Sample Size (n=<30), interpret with caution.

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As shown in Table 23, rural Registrars, who indicated doing some after hours or on-call work, do an average 18.1 hours of this type of work per week, almost double what a general pathway Registrar will do. Average hourly rates between general and rural pathway Registrars are fairly consistent however. It should be noted that when providing their average hourly rate for after hours and/or on-call work that respondents may have interpreted the question differently; i.e. some may have provided their average hourly rate for just being on-call (i.e. at home, available to work on-call) whilst others may have responded to the question in relation to what they are paid when working on-call hours; the results presented in Table 23 should thus be interpreted with caution.

Table 23: After Hours and/or On-Call Work: Average Number of Hours per Week & Average Hourly Rate - by Training Pathway Average Number of Hours Average Hourly Rate per Week Total General Rural Total General Rural Average 14.4 9.5 18.1 $86.1 $87.2 $85.3 Maximum 100 72 100 $500 $300 $500 Minimum 1 1 1 $5 $10 $5 Standard 16.7 11.0 19.2 $80.2 $64 $91.2 Deviation No. of 167 72 95 129 56 73 Responses Q26. How many hours of after hours and/or on-call work do you do on average? & Q27. What is your average hourly rate for after hours and/or on-call work?

Base: Respondents who indicated that they do after hours and/or on-call work

Chart 8: Paid On-Call Allowance Regardless of Whether See Patients or Not - by Pathway

Q28. Are you paid an on-call allowance regardless of whether you see patients? Base: Those respondents who indicated that they do after hours or on-call work (n=180)

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Respondents were asked about whether they are paid an on-call allowance regardless of whether they see patients or not; Registrars are generally not paid if this is the case (67%), albeit rural Registrars are more likely than are general pathway Registrars to be paid this allowance just for being on-call (42% vs. 21% general).

7.3 Negotiating Terms of Employment Respondents were asked a series of questions in order to determine to what extent Registrars across Australia are involved in negotiating their employment conditions, how they found this process and what they think would assist them in negotiating in the future.

Chart 9: Negotiated Current Employment Conditions - by Term Currently In

Q29. Did you negotiate your current employment conditions? Base: All Respondents (n=319; n=116 did not answer this question)

Around four in every ten Registrars (44%) appear to have negotiated their current employment conditions (see Chart 9). Given that all Registrars can, or should have the opportunity to, negotiate the terms of their employment with their medical practice, this proportion is curiously low. This result can be interpreted in a number of ways; it could suggest that many Registrars are not given the opportunity to negotiate, that they are happy to sign on under the conditions of the practice and/or Supervisor, or that they are not aware they need to/can negotiate. These are areas that could be explored further in future.

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The results by segment suggest that Registrars are more comfortable or more likely to be given the opportunity to negotiate their work conditions with their employer the further into their training they are; GPT3 Registrars and those undertaking extended or special skills, were particularly likely to have negotiated their work conditions with their employer (57% and 65% respectively). And whilst there were no significant differences at the gender or training workload levels, general pathway Registrars were more likely than rural Registrars to have negotiated their employment conditions (49% vs. 37% rural) (see Chart 10).

Chart 10: Negotiated Current Employment Conditions - by Pathway

Q29. Did you negotiate your current employment conditions? Base: All Respondents (n=116 did not answer this question)

Just under half of all respondents who indicated that they negotiated their current work conditions achieved a positive outcome (42%). Unfortunately, a small proportion of those Registrars who were able to achieve contract changes from these negotiations, felt that this had a negative effect on their relationship with their practice (17%) (see Chart 12).

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Chart 11: Changes Made to Contract as a Result of Negotiations

Q30. Were any changes made to your contract as a result of negotiations? Base: Those respondents who negotiated their current employment conditions (as at Q29) (n=133)

Chart 12: Negotiated Contract Changes Had Adverse Effect on Relationship with Practice

Q31. If answered yes at Q30, did this have any adverse effect on your relationship with your practice? Base: Those respondents who negotiated their current employment conditions (as at Q29) and also achieved changes to their contract as a result of negotiations (as at Q30) (n=53)

Respondents were asked about how they found the negotiation process; the results indicated that Registrars definitely do need some assistance in this regard. More than half of all the respondents who had negotiated their current employment conditions found the process difficult to some extent (58%) and less than half (39%) felt confident during the negotiation process.

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Interestingly, some gender differences were apparent. Female Registrars were considerably more likely to find the process either ‘somewhat’ or ‘very’ difficult as compared to male Registrars (64% vs. 45% males). Similarly, where most male Registrars felt confident in negotiating the conditions of their term (59%), just one in three female Registrars did so (29%).

Chart 13: Difficulty of Negotiation Process - by Gender

58% Difficult

45% Difficult

64% Difficult

Q32. How did you find the negotiation process? Those respondents who negotiated their current employment conditions (as at Q29) (n=139)

Chart 14: Confidence in Negotiating Conditions of Term with Employer – by Gender

39% Confident

59% Confident 29% Confident

Q33. How confident did you feel negotiating the conditions of the term with your employer?

Those respondents who negotiated their current employment conditions (as at Q29) (n=140)

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There was insufficient sample for GPT1 Registrars to compare the results at the Term level, although the results provide some indication that the process becomes easier for Registrars the longer into their training they are; half of the GPT3 Registrars (50%) found the negotiation process difficult (compared to 58% of the total sample) and almost half (47%) felt confident negotiating (vs. 39% of the total sample).

Chart 15: RTP Provided Assistance with the Negotiation Process during GPT1 and/or GPT2

Q34. Did your RTP provide any assistance with the negotiation process during GPT1 and GPT2? Base: All Respondents (n=258; note that n=58 ‘not applicable’ responses were removed from the base and n=119 did not answer the question)

Respondents were asked whether their RTP assisted them with the negotiation process during GPT1 and/or GPT2; just 20% of respondents indicated in the affirmative. Where assistance was provided by RTPs, most respondents indicated receiving basic verbal advice (56%) and around half were provided with contract templates (48%) (see Chart 16).

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Chart 16: Assistance Provided by RTP

Q35. If the RTP assisted you with the negotiation process, what assistance was provided?

Base: Respondents who were assisted by their RTP in negotiating for GPT1 and/or GPT2 (as at Q34) (n=50)

Respondents were asked to indicate their level of satisfaction with the assistance provided by one’s RTP in negotiating their terms of employment. The results were fairly mixed with the highest proportion of respondents feeling neutral (48%) (see Chart 17). At the segment level, part-time Registrars appear to be the group most pleased with their RTP in this regard (33% very satisfied/satisfied).

The survey results suggest that only some Registrars are assisted by their RTP in negotiating their employment terms; together with the fact that many Registrars find the process difficult and/or lack confidence negotiating suggest that assisting Registrars through the negotiation process could be a key area that GPRA can enhance its support to Registrars in.

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Chart 17: Satisfaction with Assistance from RTP in Negotiating Terms of Employment

Q37b. Please indicate your level of satisfaction with each of the following… Assistance from your RTP to negotiate your terms of employment (n=241) Base: All Respondents (n=116 respondents did not answer this question and N/A responses were removed from the results).

Table 24 displays the conditions that Registrars were able to negotiate on with regards to their GPT1 and GPT2 terms (with or without the assistance of their RTP); of note is the small proportion of respondents able to negotiate on their pay cycle (9%).

Table 24: Conditions Negotiated On Percentage of in-hour billings Normal working hours Holiday leave Percentage of after-hours work Unpaid leave Teaching time (e.g. teaching medical students) After hours Salary Study leave On call Sick leave Paid leave Pay cycle (e.g. weekly, fortnightly, monthly) Percentage of hospital work Access to SIP payments Access to PIP payments Maternity/Paternity leave Super Other (please specify) – see below

% 45.5% 40.3% 26.0% 18.8% 16.9% 16.9% 16.2% 14.9% 13.0% 12.3% 10.4% 9.7% 9.1% 8.4% 8.4% 8.4% 6.5% 5.8% 7.8%

n 70 62 40 29 26 26 25 23 20 19 16 15 14 13 13 13 10 9 12

Q36. Which conditions were you able to negotiate on?

Base: Respondents who took part in negotiations for their GPT1 and GPT2 terms (n=154) Some additional comments were made at ‘other (please specify)’at Q36 (n=12) – all were individual mentions; The on call payment should be separated with basic payment; Exclusion zone distance once resigned from practice; Patients per hour and breaks; After started work hours negotiated; Told by employer to do more care

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plans; No room for negotiation; Maternity leave was unpaid; Exclusion of work zone decreased; Tried others but not negotiable; Complete flexibility with work days and hours; Rental and Accommodation.

Respondents were asked to indicate their level of satisfaction with the terms and conditions of their employment and the assistance provided by their RTP (if any) in negotiating the terms of their employment. Respondents were also asked to indicate their overall level of job satisfaction.

Whilst 60% of respondents indicated being satisfied with the terms and conditions of their employment, it is apparent that satisfaction differs markedly depending on the term the Registrar is in; just 40% of GPT1 Registrars expressed being satisfied compared to 55% of GPT2 Registrars and 75% of GPT3 Registrars. Similarly, whilst around three-quarters of all respondents (73%) indicated being satisfied with their job overall, satisfaction was at just 55% of all GPT1 Registrars, compared to 70% of GPT2 and 84% of all GPT3 Registrars.

There were also some differences at the Training Workload level; part-time Registrars appear to be more satisfied with their job overall than full-time Registrars (83% vs. 68% full-time) and they also appear to be more satisfied with the terms and conditions of their employment (68% vs. 56% full-time, approaches significance only).

Table 25: Satisfaction with Terms & Conditions, Assistance from RTP and Job Overall Satisfied Neutral DisVery N/A Very satisfied disLevel of Satisfaction satisfied satisfied Terms and conditions of 11.4% 47.6% 22.1% 12.6% 4.7% 1.6% your employment (36) (151) (70) (40) (15) (5) Overall level of job 12.7% 59.4% 17.1% 6.3% 2.9% 1.6% satisfaction (40) (187) (54) (20) (9) (5)

Total Respons es 317 315

Q37a&c. Please indicate your level of satisfaction with each of the following…

Base: All Respondents (n=116 respondents did not answer this question and N/A responses for statement b) were removed from the results)

Some respondents (n=32) made additional comments at Q37 (Overall levels of satisfaction with a) Terms and conditions of your employment; b) Assistance from your RTP to negotiate your terms of employment, and c) Overall level of job satisfaction); a sample of these are provided in Appendix C.

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7.4 Preference for a NMTC Document for GPT3 Historically GPRA has advocated not to have a minimum document for GPT3 upon advice from ours members since it has been considered that most Registrars can negotiate close to market rates by this time of their training and a minimalist document may make this negotiation difficult. It has also been the view that not having such a document provides a good learning experience in contract negotiating given that Registrars would soon be required to negotiate their own contract upon completion of training.

GPRA sought to gauge an understanding of where Registrars currently stand on the issue of having a National Minimum Terms & Conditions document for GPT3 Registrars.

Chart 18: Would Like for there to be a NMTC Document for GPT3

Q38. The current NMTC only applies to GPT1 (basic) and GPT2 (advanced). Would you like for there to be a National Minimum Terms & Conditions document for GPT3 specifically? Base: All Respondents (n=308; n=127 did not answer this question).

Only around four in every ten respondents (42%) indicated a preference for there to be a NMTC document for GPT3 specifically; the remaining were either against the idea or were not sure how they felt about this (58%), thus no clear cut result was achieved .

It is possible that some respondents might not understand the reasoning behind there not being a NMTC document (as detailed above) – this is supported by the fact that GPT3 Registrars, who would by that stage of their training have had experience negotiating, were more likely than were GPT1 Registrars to be against having an NMTC for GPT3 Registrars (42% ‘No’ vs. 26% GPT1, approaches significance) (see Table 26).

The fairly high proportion of respondents who indicated that they were unsure about having a NMTC document for GPT3 (29%) could suggest that many Registrars can see both the pros and cons for having such a document; in such case it would be worth exploring with Registrars what these pros and cons are.

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Table 26 illustrates that by GPT3, there is a clearer preference to not having a NMTC document, perhaps illustrating greater confidence that this is not necessary as Registrars progress through the training program.

Table 26: Would Like for there to be a NMTC Document for GPT3 – by Term Currently In Total Term Currently In GPT1 GPT2 GPT3 41.9% 44.7% 47.6% 35.5% Yes (129) (21) (60) (22) No 29.5% 25.5% 23.0% 41.9% (91) (12) (29) (26) Unsure 28.6% 29.8% 29.4% 22.6% (88) (14) (37) (14) No. of 308 47 126 62 Responses Q38. The current NMTC only applies to GPT1 (basic) and GPT2 (advanced). Would you like for there to be a National Minimum Terms & Conditions document for GPT3 specifically? Base: All Respondents (n=308; n=127 did not answer this question; results for GPT1, GPT2 and GPT3 respondents only shown)

The following additional comments were also made at ‘other (please specify)’at Q38 (n=12) which lent some further insight: • GPT 1 Registrar comments; o I would have worked in community health centre settings up to GPT3 so have no experience re negotiation and private billing • GPT 2 Registrar comments; o Better to give guidelines on how to negotiate seeing as we have to do that in future anyway o Or if not, more guidance and assistance from RTP as to what is reasonable to request and negotiate o It is useful to stipulate basic provisions – e.g. paid holiday leave if only on 50% billings • GPT 3 Registrar comments; o But the proviso that 50% be minimum for percentages - but a base hourly rate recommended maybe prudent o Working as an Employee under any NMTC eliminates possibility of tax-effective planning and negates the benefits of a free profession o Didn't get teaching re contract negotiating until subsequent term; by that time the subsequent term was already arranged and conditions set o It's difficult to negotiate when you have no idea what the current minimum salary/percentage billings is for GPT3 and onwards o Absolutely - once exams loom and I needed study time I was broke!! o I really didn't negotiate in Term 1 and 2, so had no idea when it came to Term 3 • Extended skills/Special skills Registrar comments; o I think there should be some things that are clear in subsequent [term] in a document, i.e. in regards to trainees not being contractors, but I think a document like the minimum terms and conditions stops our ability to negotiate.

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Chart 19: Assistance RTP Provides Registrars to Assist with Negotiation Process During GPT3 (Prompted)

Q39. As far as you are aware does your RTP provide any of the following to Registrars to assist with the negotiation process during GPT3? Base: All Respondents (n=310; n=125 did not answer this question).

As far as Registrars are aware, the main resources their RTP provides Registrars to assist with the negotiation process during GPT3 are basic verbal advice and contract templates (see Chart 19). However the most popular response was to say that they were not sure what their RTP provided in this regard (46%). The fact that this question was prompted probably also influenced the proportion saying they were aware of the resources provided (i.e. verbal advice, contract templates, written documentation and advice on contract negotiation).

GRPA would be keen to gauge the RTP perspective with regards to the extent to which they see themselves as being responsible for, or in playing a role in, assisting Registrars in negotiating their employment conditions with practices for GPT3 and other terms; particularly given that RTPs would not have a document to form their advice on.

The following additional comments were also made at ‘other (please specify)’at Q39 (n=14): • GPT 1 Registrar comment; o From RLOs and JMEs • GPT 2 Registrar comments; o Nil o I asked for and suggested these things but never got them o SLO advice o Workshop on negotiating o RACGP book on negotiating a fair deal, and a presentation form GPT3 Registrars/Practice Manager/RLOs at a basic term release day o My RTP is excellent in most circumstances however I strongly feel that this is one aspect that our education significantly lacks o I assume nothing is provided • GPT 3 Registrar comments; o They were not helpful • Extended skills/Special skills Registrar comments; o Nil help at all GPRA’s Terms and Conditions Benchmarking Survey Report 2010

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•

o Negotiation course o "They have nothing to do with contracts" o Negotiation workshop ARSP Registrar comment; o Did not offer any help with contracts when I asked

Table 27: Usefulness of Resources in Negotiating for GPT3 (Subsequent Term) (Prompted) Of some Not Not N/A Total Very use useful sure Respons Usefulness useful es a) Negotiating 50.2% 39.9% 3.2% 5.8% 1.0% guidelines manual (157) (125) (10) (18) (3) 313 b) Minimum terms and 46.9% 38.3% 6.1% 7.4% 1.3% 311 conditions document (146) (119) (19) (23) (4) c) Workshop on 49.7% 36.5% 6.1% 5.5% 2.3% 310 negotiating (154) (113) (19) (17) (7) d) Recommended 56.1% 34.9% 1.9% 6.4% 0.6% 312 contract with guidelines (175) (109) (6) (20) (2) Q40. Please indicate how useful you think each of the following resources would be in negotiating for GPT3 (subsequent term… Base: All Respondents (n=121 did not answer this question)

Respondents were asked to rate a range of resources for usefulness in negotiating for the GPT3 term. Whilst all prompted resources were rated as being useful by the majority (see Table 23), a ‘Recommended contract with guidelines’ was the most popular resource (56% ‘very useful’) – note that this lay ahead of having a Minimum Terms and Conditions document (47% ‘very useful’).

Respondents were also asked (at Q41) to indicate in their own words what would assist them to negotiate their employment contracts, whether there were any other resources GPRA could provide them with. Respondents’ suggestions are provided in full in Appendix D – popular suggestions included providing Registrars with market rates of what can be earned at each stage of training, various examples of negotiated contracts and even contracts by medical practice/location; an interesting suggestion (or theme in the comments) was having someone who’s available to go along with a Registrar when negotiating with their practice.

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The results from the Terms and Conditions Benchmarking survey suggest that negotiating the terms and conditions of their employment is a difficult process for many Registrars. Whilst there is some suggestion in the data that the process may becomes somewhat less difficult with experience (albeit not many Registrars actually negotiate their terms in GPT1 and GPT2), what comes through more strongly is the need to provide Registrars with much better support in this area. Whilst support can come in the form of tools to help with negotiating, e.g. a recommended contract with guidelines, support is also needed by way of making sure Registrars are clear on what their rights are and also protecting those who do not, or are not able to, develop good negotiation skills.

In relation to having a NMTC document specifically for GPT3, GPRA would like to explore the option of having a document which outlines the general conditions under which a GPT3 Registrar should be employed under, as opposed to a formal agreement for GPT3 which could be limiting for some Registrars. Such a document, which could be in the form of a Memorandum of Understanding, would outline that an agreement between a Registrar and practice in GPT3 should not be below the entitlements outlined in the NMTCs for GPT1 and GPT2. This document would also detail that a written contract is a minimum standard between GPT3 Registrars and their practices.

7.5 Compliance with the NMTC Document for GPT1 & GPT2 Registrars Respondents were asked a series of questions to gauge general compliance by employers to the National Minimum Terms and Conditions for GPT1 and GPT2.

The results suggest that in general the vast majority of employers of GPT1 and GPT2 Registrars do comply with these mandatory conditions, however it is apparent that breaches of the NMTCs do occur and need to be addressed.

It appears that almost one in ten Registrars during their GPT1 and/or GPT2 terms are employed as contractors (8%, see Chart 20). Further, there are RTPs (2%), practices (8%) and supervisors (5%) that are involved in either encouraging or forcing Registrars to work as contractors during GPT1 and/or GPT2 (see Chart 21). It must be acknowledged that there may be some misunderstanding about what basis Registrars is employed on, or cases where the Registrar is legitimately working in a salaried position e.g. in an Aboriginal Medical Service or working primarily for a rural hospital.

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Chart 20: Working/Worked as an Employee During GPT1 and GPT2

Q42. Did you work (or are your working) as an employee during GPT1 (basic) and GPT2 (advanced)?

Base: All Respondents (n=300; n=135 respondents did not answer this question).

Chart 21: Ever Forced or Encouraged to Work as a Contractor during GPT1 and/or GPT2

Q43. Were you ever forced/encouraged to work as a contractor during GPT1 and GPT2 by your …RTP/Practice/Supervisor? Base: All Respondents (n=301; n=134 did not answer this question).

The following additional comments were also made at ‘other (please specify)’at Q43 (n=10): • Unsure, if this is how arrangement with hospital is considered • Rural hospital • This was never really clear • Would like to work as contractor but told not possible while in training program • Not sure what this mean. You only work for 6 months? Contract • I was happy with this arrangement • My first term supervisor wouldn’t pay holiday leave and didn’t compensate this with higher % of billings, very different to my second supervisor!

• Practice was taken over by IPN part way through my training • Contracted for VMO work • We are all paid only a % plus super. No employee conditions are adhered to - so no sick leave, annual leave GPRA’s Terms and Conditions Benchmarking Survey Report 2010

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Other areas of non-compliance with the NMTCs for GPT1 and GPT2 are also suggested in the results with regards to various aspects of Registrars’ training. For instance, small proportions of respondents indicated that they felt the ordinary hours of work are more onerous for Registrars than for other GPs at their practice (11%); similarly with regards to the after-hours and on call arrangements at their practice (7%).

More concerning perhaps is the fact that as high as 13% of respondents don’t feel that they get the recommended supervision for basic and advanced terms (13%). Further a considerable proportion indicated that they regularly see more than the maximum recommended 4 patients per hour (15%) and/or being dissatisfied with the personal safety arrangements at their practice (12%).

At the segment level, there were some noteworthy differences; compared to part-time Registrars, full-time Registrars were more likely to agree that the ordinary hours of work at their practice were more onerous for Registrars than for other GPs (13% vs. 4% part-time) and were less likely to agree that they didn’t see more than 4 patients per hour (74% vs. 87% parttime). There were also some differences by gender; compared to female Registrars, male Registrars were less likely to agree that they didn’t see more than 4 patients per hour (68% vs.

82% females) and less likely to say that they weren’t satisfied with the personal safety arrangements at their practice (4% vs. 16% females).

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Chart 22.1: Attitudes towards Employer Compliance with NMTC for GPT1 and GPT2

100% 90%

5.9 7.3

11.3 4.7

80%

10.2 3.3 12.5

N/A Unsure

70%

No

60%

Yes

50%

76.6

77.7

40%

75.1

30% 20% 10% 10.6 0%

7

I get the recommended The ordinary hours of work at The after hours and on call my practice are more arrangements are more supervision at my practice for onerous for Registrars than onerous for Registrars than basic and advanced terms (n=305) for other GPs at the practice other GPs at the practice (n=303) (n=301)

Q44. Please answer the following…Yes/No/Unsure/Not Applicable? Base: All Respondents (n=307; n=128 did not answer this question at all).

Chart 22.2: Attitudes towards Employer Compliance with NMTC for GPT1 and GPT2

100% 90%

3.7 3.7 6.3

5.6 2

4.3 9.9

14.8

80%

11.9

N/A Unsure

70%

No

60%

Yes

50% 40%

86.4

78.3

74.2

30% 20% 10% 0% I can always contact my supervisor or a nominated person in case of an emergency (n=301)

I normally don’t see more I am satisfied with the than 4 patients per hour at personal safety arrangements my practice (n=304) at my practice (n=302)

Q44. Please answer the following…Yes/No/Unsure/Not Applicable? Base: All Respondents (n=307; n=128 did not answer this question at all).

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7.6 Educational Release Time Respondents were asked about whether they are paid for educational release time from the training program, and if so, who pays for this - their practice or RTP. The results indicate that currently around two-thirds of all Registrars (69%) receive paid educational release time. The results also indicate that the further into their training they are, the less likely a Registrar is paid for this time (see Chart 23). Perhaps this is because more Registrars may be earning a percentage, and hence less likely to get paid specifically for their educational release time. With regards to who pays for their educational release time, most believe it’s their medical practice (41%), however there’s a high degree of uncertainty (47% ‘not sure’, see Chart 24).

Educational release time, together with clinical time and supervision time, form Registrars’ ordinary hours of work. GPRA advocate that all educational release time should be paid.

Chart 23: Paid Educational Release Time from the Training Program

Q45. I get paid educational release time from the training program… Base: All Respondents (n=301; n=134 respondents did not answer this question). *Note: Small Sample Size (n=<30), interpret with caution

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Chart 24: Educational Release Time Paid by …

Q46. This release time is paid by the… Base: All Respondents (n=252; n=183 did not answer this question)

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7.7 Sick Leave, Annual Leave, Public Holidays and Other Leave Federal Legislation mandates that all employees in Australia be paid sick leave, annual leave and carer’s leave and for working on public holidays. In order to gain a measure of the extent to which this is adhered to amongst employers of GP Registrars, respondents were asked about whether they were, firstly, able to take the various leave types and also if they were paid if they took this leave. Respondents were also asked about whether they are paid for other aspects of their work (e.g. study leave and SIPs) which in cases can be paid by employers of GP Registrars.

Whether respondents are allowed to take various types of leave are displayed in Table 28. It is of considerable concern to GPRA that there are breaches of the National Standards amongst employers of Registrars. In particular the fact that substantial proportions of respondents are not able to take sick leave (7%) and/or carer’s leave (16%) and that there are some Registrars not able to take annual leave (2%).

The other main concern for GPRA with regards to the types of leave Registrars believe they can take, is the high degree of uncertainty that surrounds maternity/paternity leave, carers leave and study leave (46%, 40% and 27% respectively). Only around a third of Registrars (36%) are aware that they can take maternity/paternity leave; this result however could be influenced by the fact that some Registrars, such as single men and others not in need of this type of leave, may not have had to think about maternity/paternity leave before.

GPRA would like to see the types of leave all Registrars are entitled to be made completely transparent to Registrars upon their employment, and optimally, included in their employment contracts.

Table 28: Leave Able to Take

a) Sick leave b) Annual leave c) Study leave d) Maternity/Paternity leave

Yes 89.7% (269) 95.3% (286) 45.6% (135) 35.7% (100)

No 7.3% (22) 2.3% (7) 27.7% (82) 18.6% (52)

e) Carers Leave

43.9% (125)

16.1% (46)

f) Public holidays

89.1% (262)

4.1% (12)

Unsure 3.0% (9) 2.3% (7) 26.7% (79) 45.7% (128) 40.0% (114) 6.8% (20)

Response Count 300 300 296 280 285 294

Q47. I am able to take… Base: All Respondents (n=134 respondents did not answer this question at all)

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Some respondents made additional comments at ‘other (please specify)’at Q47 (leave able to take) (n=43). The following is a sample: • All leave above is unpaid • No maternity leave while training is disgustingly unfair - I have had 2 children during my training and had no maternity leave paid making life very hard • Unpaid maternity leave, public holidays if not rostered • In theory I can take the above - in practice I always have to spend hours on the phone chasing my leave pay - last sick leave day took nearly 5 months to be paid after numerous phone calls • I have been told that I should not be sick suddenly • Not enough doctors to easily take sick/carers leave • Not during my current term as I am contractor; but I could before • Theoretically I am entitled to Sick, Study and Carer's leave however (calculating on a fortnightly basis) if my earnings are greater than my minimum wage (with the leave added) then the leave in effect gets 'absorbed' (actually this applies to annual leave if I take it in a small enough block • Maternity leave unpaid - financially stressful. Because forced to rotate, not eligible for payment • Ended my contract before taking maternity leave • Depends on roster. Huge pressure to work when you are sick due to patient load • Annual leave was made difficult, unapproachable and not paid when occured early in term • I had conflict with my current employer over my holiday pay, it seems that despite our contract my employer thinks it is appropriate to deduct my holiday pay from me percentage takings • Not sure of the details on this • All of above can be taken but unpaid by [RTP] • But all unpaid as I am a contractor

Table 29 shows the various aspects of work that respondents understand they are paid for.

The results indicate that there are many employers not paying Registrars for the mandatory sick leave, annual leave, carers leave and for working on public holidays. Whilst a small portion of the sample were employed as contractors (contractor or contractor and employee, 14%), and thus are not required to be paid for things such as annual leave, it does not explain why not more Registrars are not paid for all mandatory leave. One explanation may be that when Registrar’s are paid a percentage, rather than a base wage it can be interpreted that they are not receiving paid leave, as in fact it results in a lower percentage earned.

The fact that one in ten Registrars doesn’t believe their employer pays them superannuation (11%) is noteworthy, as is the very low proportion of respondents who are of the understanding that they can be paid for maternity/paternity leave (18%). It should be noted that a ‘don’t know’ option was not included for this question and thus some ‘no’s’ may be respondents saying they are unsure if they are paid for that aspect of their work or not (this is supported by some of the verbatim comments made at ‘other – please specify’ also).

The results for this measure are also displayed in Appendix E by the condition respondents are employed as (i.e. employees, contractors or both).

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Table 29: Aspects of Work that are Paid

a) Sick leave b) Annual leave c) Study leave d) Maternity/Paternity leave e) Carers Leave f) Public holidays g) Superannuation h) SIPS (maybe a portion of this) i) PIPS (maybe a portion of this)

Yes 76.5% (225) 82.6% (246) 28.6% (69) 17.9% (39) 37.9% (88) 63.5% (172) 89.5% (255) 50.4% (118)

No 23.5% (69) 17.4% (52) 71.4% (172) 82.1% (179) 62.1% (144) 36.5% (99) 10.5% (30) 49.6% (116)

Response Count 294 298 241 218 232 271 285 234

39.6% (89)

60.4% (136)

225

Q48. The following aspects of my work are paid… Base: All Respondents (n=133 respondents did not answer this question at all)

Some respondents made additional comments at ‘other (please specify)’at Q48 (Aspects of work that are paid) (n=29). The following is a sample: • Although some of the above are paid, if you have already gone over the minimum fortnightly/weekly wage with percentage earnings, the days are essentially not paid • Paid as long as salary greater than percentage for that fortnight • The sick pay rate was half the normal daily rate • I work in a hospital not accredited GP practice • Unsure re study leave. Think this would be counted as annual leave • Unsure if sick/paternity/cares leave are paid • Sick and annual leave paid if accrued (impossible to accrue two weeks annual leave before last day of term!)

• Unsure on a few

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7.8 Additional Work outside Training Program As a means of capturing a complete picture of Registrars’ commitments, respondents were asked a series of questions regarding any work they may be doing outside of the AGPT program.

Table 30: Additional Work outside Training Program In addition to work outside training program…

Yes a) Currently engaged in additional work 28.0% (109) b) Have done it in the past 37.0% (138) c) Would like to do in the future 60.9% (213) d) Unsure 40.7% (59)

No 72.0% (280) 63.0% (235) 39.1% (137) 59.3% (86)

Response Count 389 373 350 145

Q12. In relation to additional work outside of the training program, are you…

Base: All Respondents (n=39 did not answer this question)

As high as one in every four respondents (28%) indicated being engaged in work outside the requirements of the AGPT program which is quite a substantial proportion of Registrars. This indicates that the program does allow Registrars flexibility to pursue their personal interests outside their GP training. A similar proportion had previously undertaken additional work (37%). These results may indicate that Registrars need to do work outside the training program to financially support themselves.

Almost two-thirds of respondents indicated being interested in doing additional work outside the program (61%); a strong indicator that the AGPT program should remain flexible enough for Registrars to do specialist work outside the program should they wish to.

Looking at the results by gender, it is apparent that male GP Registrars have had more of an interest in undertaking work outside the program than female Registrars. Compare to female Registrars, male Registrars were more likely to be currently engaged in additional work (37% vs. 24% females) and to have done some in the past (45% vs. 33% females), albeit, males and females were equally likely to want to do additional work in the future (64% males, 59% females).

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GPRA are of the position that a Registrar who is interested in undertaking work outside the AGPT program should be allowed to do so as long as the Registrar complies with safe working hours for doctors; such flexibility gives Registrars the opportunity to expand on their skill set and thus become more well-rounded GPs. GPRA recommends that any Registrar interested in undertaking work outside the AGPT program does this is in consultation with their RTP. GPRA believes that RTPs should not stop a Registrar from doing additional work unless there is a clear and valid reason. It is somewhat surprising to see that a fairly low proportion of Registrars who indicated completing additional work (27%) had this work approved by their RTP (see Table 31 and for the nature of additional work completed).

Table 31: Additional Work – Approval by RTP and Nature of Work If completed additional work outside of training program, % was approved by one’s RTP Yes 26.6% No 42.4% Don’t know 31.0% Nature of the additional work completed Hospital* 48.7% Locum* 46.8% Teaching (outside the training program) 15.2% Other (see below) 21.5%

n 42 67 49 77 74 24 34

Q13. If you completed additional work outside of the training program, was this approved by the RTP? Q14. What was the nature of the additional work you completed?

Base: Respondents who indicated having completed additional work (n=158) *Rural Registrars were more likely to have undertaken additional work in a hospital (56% vs. 37% general Registrars), whilst general Registrars were more likely to have done teaching outside the program (19% vs. 7% rural Registrars).

The ‘other’ responses for Q.14, Nature of Additional Work Completed (n=34), were as follows: • Other business/own business/Different business outside medicine, 6 responses • Surgical assisting, n=6 • RLO/work with RTP, n=5 The following were individual responses at Q.14 ‘other’; Anaesthetics, Board appointment, Continued some casual work with special skills term employer, Corporate Clinic, Extra sessions at a GP practice, Forensic medical work, GP after hours clinic, GP afterhours work whilst doing special skills term in hospital, Medical Officer for Defence, Nursing home/home visits, Occupational medicine, On calls, Other medical officer, Private assisting, Private consultations, Sports medicine - extended skills, Subspecialty practice - nutritional medicine, Visa medicals, VMO at local hospital, Volunteer with international health, Watercraft operator.

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8. Appendices

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Appendix A – Weekly Registrar Earnings: Results from GPRA’s Training Time Survey 2010 Table 32: Average Amount Earned Each Week for Ordinary Hours in General Practice, Excluding Overtime and/or On-Call – by GP Term Currently In GP Term Total Extended Skills/ Hospital GPT1 GPT2 GPT3 Special Skills Term Other Average $2,157 $2,038 $2,149 $2,283 $2,190 $1,354 $2,766 Maximum $6,000 $6,000 $5,000 $6,000 $5,000 $4,000 $5,200 Minimum $130 $450 $500 $600 $130 $320 $700 Standard $1,169 $1,144 $1,234 $1,155 $1,074 $876 $1,422 Deviation No. of Responses

289

101

27

97

33

14*

17*

Q11. Estimate how much you earn each week for ordinary hours in general practice EXCLUSIVE of overtime or on call? Please enter gross weekly earnings (i.e. before tax is taken out) Base: All Respondents (n=289; n=68 did not answer this question and n=4 outliers were removed) *Note: Small Sample Size (n=<30), interpret with caution.

Table 33: Average Amount Earned Each Week for Ordinary Hours in General Practice, Excluding Overtime and/or On-Call – by Training Workload Total Full-Time Part-Time Total Total Average $2,157 $2,379 $1,452 Maximum $6,000 $6,000 $4,000 Minimum $130 $130 $150 Standard $1,189 $755 $1,169 Deviation No. of Responses

289

220

69

Q11. Estimate how much you earn each week for ordinary hours in general practice EXCLUSIVE of overtime or on call? Please enter gross weekly earnings (i.e. before tax is taken out) Base: All Respondents (n=289; n=68 did not answer this question and n=4 outliers were removed) *Note: Small Sample Size (n=<30), interpret with caution.

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Appendix B – Survey questionnaire Q1. Age • 20-25 • 26-30 • 31-35 • 36-40 • 41-45 • 46-50 • Over 50 Q2. Gender • Male • Female Q3. Regional Training Provider • Adelaide to Outback General Practice Training Program • Bogong Regional Training Network • Central & Southern Queensland Training Consortium • CoastCityCountry Training • General Practice Training Tasmania • General Practice Training Valley to Coast • Gippsland Education & Training for General Practice • GP Synergy • GPlogic • Greater Green Triangle General Practice Training & Education • Institute of General Practice Education • North Coast GP Training • Northern Territory General Practice Education • Rural & Regional Queensland Consortium • Remote Vocational Training Scheme • Sturt Fleurieu General Practice Education & Training • Tropical Medical Training • Victoria Felix Medical Education • Victorian Metropolitan Alliance • WentWest • Western Australian General Practice Education & Training

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Q4. Training Pathway • •

Rural General

Q5. What is your training workload?

• Full-time • Part-time Q6. What term are you currently in?

• GPT1 • GPT2 • GPT3 • Extended skills/Special skills • ARSP • Academic Post • Other (please specify) Q7. Which of the following endpoints are you training towards?

• FRACGP • FACRRM • FARGP • Other (please specify) Q8. Are you aware of the National Minimum Terms & Conditions document for GPT1 (basic) and GPT2 (advanced) Registrars?

• Yes • No Q9. Do you have a signed paper contract with your current employer?

• Yes • No Q10. Did you refer to the NMTC document when determining your employment arrangements?

• Yes • No Q11. Are you employed as a(n)?

• Employee • Contractor • Both (working at more than one location) • Unsure

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Q12. In relation to additional work outside of the training program, are you …

(Yes/No response options for each) a) b) c) d)

Currently engaged in additional work?

Have done it in the past?

Would like to do in the future?

Unsure?

Q13. If you completed additional work outside of the training program, was this approved by the RTP?…

• Yes • No • Don’t know • Not applicable Q14. What was the nature of the additional work you completed?

• Hospital • Locum • Teaching (outside the training program) • Not applicable • Other (please specify) Q15. Which of the following benefits does your employer offer you, in addition to your salary?

(Yes/No response options for each) a) Rental subsidy? b) Accommodation assistance? c) Travel reimbursements? d) Salary packaging options? e) Not sure?

Other (please specify) Q16. Do you have autonomy to choose how your patients are billed? i.e private or bulk bill?

• Always • Almost always • Within broad guidelines • Sometimes • Almost never • Never • Other comments

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Q17. Please provide an estimate of your billing profile (total must add to 100) (Option for each were; 0%, <5%, 5%, 10%, 20%, 30%, 40%, 50%, 60%, 70%, 80%, 90%, 100%) a) b) c) d)

Percentage that is Bulk billed?

Percentage that is Private billed Percentage of Workcover billings Other miscellaneous billings

Q18. What are your average gross weekly earnings from work within training program including after hours and on call (please enter whole number without any symbols or '$' sign)?

(Open-ended question) Q19. How many sessions from work within the training program (one session is typically 3-4 hrs) per week do you do on average? Please enter nearest whole number?

(Open-ended question) Q20. For ordinary hours of work, I am paid …

• A fixed salary • A percentage of billings • A base salary or percentage of billings whichever is greater • Not sure Q21. If you are paid a base salary, is this salary…

• N/A • Equal to NMTC • Less than NMTC • Greater than NMTC Q22. If you are paid a percentage, what is the percentage?

• 40% • 45% • 50% • 55% • 60% • 65% • 70% • 75% • >75%

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Q23. If applicable, is the percentage calculated …

• • • • • •

Weekly Fortnightly Monthly Three monthly Not applicable Other (please specify)

Q24. Do you do after hours or on-call work?

• Yes • No Q25. For after hours or on-call work, I am paid…

• A fixed salary • A percentage • A base salary or a percentage of billings, whichever is greater Q26. How many hours of after hours and/or on-call work do you do on average?

(Open-ended question) Q27. What is your average hourly rate for after hours and/or on-call works? (please enter an actual amount or an approximate amount if it is based on a percentage)?

(Open-ended question) Q28. Are you paid an on-call allowance regardless of whether you see patients?

• Yes • No Q29. Did you negotiate your current employment conditions?

• Yes • No Q30. Were any changes made to your contract as a result of negotitations?

• Yes • No • Not applicable

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Q31. If answered yes to question Q30, did this have any adverse affect on your relationship with your practice?

• Yes • No • Not applicable Comments (please specify) Q32. How did you find the negotiation process?

• Very difficult • Somewhat difficult • Fine • Easy • Very easy • N/A Q33. How confident did you feel negotiating the conditions of the term with your employer?

• Very confident • Fairly confident • Not that confident • Not at all confident • N/A Q34. Did your RTP provide any assistance with the negotiation process during GPT1 and/or GPT2?

• No • No assistance was provided as far as I was aware • Assistance was available, but I chose not to take it • Assistance was available but I did not know about it until later • Yes • Not applicable Q35. If the RTP assisted you with the negotiation process, what assistance was provided?

• Some basic verbal advice from RTP staff • Contract templates were provided • Written documentation and substantial advice on contract negotiation was provided • Not applicable • Other (please specify)

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Q36. Which conditions were you able to negotiate on? Click all that apply…

• • • • • • • • • • • • • • • • • • • •

Percentage of in-hour billings Percentage of after-hours work Percentage of hospital work Salary Sick leave Study leave Holiday leave Maternity/paternity leave Pay cycle (e.g. weekly, fortnightly, monthly) Access to SIP payments Access to PIP payments Normal working hours After hours On call Paid leave Unpaid leave Super Teaching time (e.g. teaching medical students) Other (please specify) Not applicable

Q37. Please indicate your level of satisfaction with each of the following…

(Very satisfied/Satisfied/Neutral/Dissatisfied/Very dissatisfied/N/A response options for each) a) Terms and conditions of your employment? b) Assistance from your RTP to negotiate your terms of employment? c) Overall level of job satisfaction?

Comments (please specify) Q38. The current NMTC only applies to GPT1 (basic) and GPT2 (advanced). Would you like for there to be a National Minimum Terms & Conditions document for GPT3 specifically?

(Historically GPRA has advocated not to have a minimum document for GPT3 upon advice from our members since it has been considered that most Registrars can negotiate close to market rates by this time of their training and a minimalist document may make this negotiation difficult. It has also been the view that this provides a good learning experience in terms of contract negotiation given that Registrars would soon be required to negotiate their own contract upon completion of training)?

• Yes • No • Unsure

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Q39. As far as you are aware does your RTP provide any of the following to Registrars to assist with the negotiation process during GPT3?

• • • • •

Basic verbal advice Contract templates Written documentation and advice on contract negotiation Don’t know Other (please specify)

Q40. Please indicate how useful you think each of the following resources would be in negotiating for GPT3 (subsequent term)?

(Very useful/Of some use/Not useful/Not sure/N/A response options for each) a) b) c) d)

Negotiating guidelines manual?

Minimum terms and conditions document Workshop on negotiating Recommended contract with guidelines

Q41. What would assist you in your ability to negotiate your employment contracts? Are there any resources that you would like GPRA to provide?

(Open-ended question) Q42. Did you work (or are your working) as an employee during GPT1 (basic) and GPT2 (advanced)?

• Yes • No Q43. Were you ever forced/encouraged to work as a contractor during GPT1 and GPT2 by your…

(Yes/No/N/A response options for each) a) RTP? b) Practice? c) Supervisor?

Other (please specify) Q44. Please answer the following…

(Yes/No/Unsure/N/A response options for each) a) The ordinary hours of work at my practice are more onerous for Registrars than for other GPs at the practice? b) The after hours and on call arrangements are more onerous for Registrars than other GPs at the practice? c) I get the recommended supervision at my practice for basic and advanced terms? d) I can always contact my supervisor or a nominated person in case of an emergency? e) I normally don’t see more than 4 patients per hour at my practice? f) I am satisfied with the personal safety arrangements at my practice?

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Q45. I get paid educational release time from the training program?

• •

Yes No

Q46. This release time is paid by the…

• Practice • RTP • Not sure Q47. I am able to take…

(Yes/No/Unsure response options for each) a) Sick leave? b) Annual leave? c) Study leave? d) Maternity/paternity leave? e) Carers leave? f) Public holidays?

Comments (please specify) Q48. The following aspects of my work are paid…

(Yes/No response options for each) a) Sick leave? b) Annual leave? c) Study leave? d) Maternity/paternity leave? e) Carers leave? f) Public holidays? g) Superannuation? h) SIPs (maybe a portion of this)? i) PIPs (maybe a portion of this)?

Comments (please specify)

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Appendix C – Verbatim responses provided at Q37 (Overall levels of satisfaction) Q37. Please indicate your level of satisfaction with each of the following? a) Terms and conditions of your employment; b) Assistance from your RTP to negotiate your terms of employment, and c) Overall level of job satisfaction

A sample of the verbatim responses (n=32) provided at Q37 (at additional comments) are listed below: •

• • • • • •

•

• • • •

• • • • • • •

Hard to negotiate for Basic term. Probably could have at 3 month mark because of high billings but found it difficult given supervisor-registrar relationship as well as employer-employee relationship.

NSW health employee - options are limited, did not choose the practice but was allocated it, excellent teaching.

More transparency to know what aspects of payment are negotiable, and what is considered reasonable.

Politics and workforce shortage are causing the friction, not the clientele.

Were not given advice until second term, when we had endured all issues from first term and inequality amongst Registrars.

General practice is tough work and I don't know if I could ever be paid enough to actually enjoy it.

Most of the other registrars I talk to have their percentage calculated fortnightly as oppose to 3 monthly. I have been at the same practice for GPT1 and GPT2 and have tried twice to negotiate this fortnighthly. It makes a significant difference to pay being calculated 3 monthly. In addition to being taxed higher, the actual pay is less if you have taken leave/have a 2 day workshop etc. For example, I am about to take 4 weeks leave and I know that I will not make the 45% threshhold this three months and I feel very unhappy working hard and seeing lots of patients and feeling exhausted at the end of the day just to get my base wage. If I were being paid fortnightly I would make significantly more money. This is one aspect of the NMTC that I think should be changed.

I feel that now I have not done things formerly (in my basic term) I can't go back and renegotiate my advanced term. Have tried and my boss says that if they increase my percentage >45% then the other fellowed doctors in the practice will be getting more than me! How can that be so?!

There is no transparency. GPR are in a vulnerable position and should be more supported in this area.

Minimum terms and conditions favour employers. To my employer I am there for the company, extra income solely. Most GPs in the Division gang up and hold monopoly of the rate/terms.

Have some low billing days and would like to work more hours, but overall happy.

Feel overworked and that the on-call burden is far too onerous (a view shared by some other fully qualified local doctors).

Much happier now am further through training, so can choose a practice which allows me to negotiate on pay/hours etc. Not happy with the "what we say goes" attitude of practices in basic and advanced term.

I believe the base rate of pay is too low, especially in GPT1.

I had a lot of trouble with NMTC in my last post in GPT2. Not much support.

Frustrated due to very high percentage of bulk billing which is not in your control Apart from supplying contract templates, the RTP has a very minimal role in negotiating contract conditions.

I am paid well above the NMTC for clinical work but well below for my academic work.

Low percentage - impossible to negotiate but good working conditions/staff so have overlooked that negative aspect.

I don't like that we still only get 45% of billings as a GPT2 when previously was higher.

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• •

Employer very flexible and accommodating with my family needs (children and professional husband).

Subsequent Registrars need benefit of inclusion in National minimum terms and conditions.

Unhappy that these last terms of training excluded from this document.

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Appendix D – Verbatim responses provided at Q41 (What would assist in negotiating employment contracts) Q41. What would assist you in your ability to negotiate your employment contracts? Are there any resources that you would like GPRA to provide?

All verbatim responses are listed below and are listed by the term the respondent was in: GPT1 Registrars: • •

•

• •

• • • •

• • •

What a GP earns on average in specific areas.

Having someone to shoot evil practice managers. In all seriousness, some Practice Managers look at the NMTC as "guidelines"; I had a failed interview with a practice for GPT2 because I asked to negotiate a contract above 45% (who were also not willing to pay holidays or sick leave). Maybe having somewhere to report that kind of practice to someone who would actually follow up on it would be nice.

I would like to know the current market rates and the details of negotiation, e.g. hospital work, oncall frequency, SIP payments (what is that?), and other things e.g. nursing home patients and duty-doctor (for walk-ins) etc.

Each practice profile and Registrar rates.

Perhaps the minimum terms and conditions for employees in Australia or NSW, as I believe the NMTC for registrars should reflect the work conditions in terms of sick leave, LWOP, etc that exist in other workplaces. Perhaps compulsory timesheets, or a package for practices and registrars including conditions and timesheets, reimbursement forms, etc, which makes it easier.

Anything.

Having a recommended contract would be useful as a guide.

Current rates.

Increasing the percentage of minimum wage as in basic and advanced term every registrar finds it very difficult to negotiate with their supervisors regarding percentage of billings. This is because they are the junior most in the clinic and are concerned about their relationship with supervisor by asking for a higher share.

Advice on what is reasonable to negotiate.

Positions and on call works after GP clinic work.

Ability to negotiate with the hospital/WA Country Health Service about on call arrangement for local hospital (this service is an expected part of the job, it is not optional).

GPT2 Registrars: • • • • • • • • • • •

Case study will be useful for us to gain insight.

RTP support of the NMTC would be a start.

Knowing on average what you can expect to earn as a registrar at each particular stage of training.

Contract with guidelines.

An average of "market rates" in the area of work.

Minimum terms and conditions.

A better understanding of what is expected by employers.

Talk before any negotiation.

Ability to go to a different practice if you can't successfully negotiate.

Advice and small workshop.

Contract, negotiation documents.

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•

• • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • •

Yes - if there was some way you could make a document with the different percentages/pay/perks that subsequent year Registrars get on average that would be useful, so we can compare to see if we are getting "ripped off".

Workshop towards end of year 1 training.

Guideline.

Knowing what the other GPs in the area are getting.

Anything is better than nothing.

Guidelines with points to consider such as years of experience, comparison to other GPs in practice etc to go through in negotiation to give me confidence to raise this at contract meeting.

Support from the RTP within the process e.g. requiring a copy of the job contract and talking to practices about what is expected.

Increase the minimum billing % from 45% to 50%.

Knowing what the majority of other Registrars in the area are being paid. I think that subsequent Registrars should be on a minimum 60% and if this is across the board.

Not at all confident, don't know what to ask for, feel "thrown to the wolves".

Basic guidelines or sample contracts from different Registrars.

Terms and conditions.

Any help whatsoever.

Minimal terms and conditions.

Outlining the various options and their pros and cons, i.e. contract being simpler and easier to manage versus contractor having some complexity but potentially more rewards.

Someone like an RLO going with me to the interview.

Registrars should be paid in accordance with their competency, not according to terms e.g.

GPT1, GPT2 etc.

Previous Registrar experience.

Employers currently block negotiation; there is no incentive for them to negotiate.

Guidelines on current terms and conditions for GPT3 throughout all RTPs as a basis for negotiations.

What are we worth in real terms? Access to these through the GPRA website would be valuable.

Information of what the average GP has on their contract and average rates of pay/percentages for fully trained GPs in different areas.

All items (at Q40) plus a single defined advocate to go into bat for conned/used/abused Registrars.

Better minimum terms and conditions.

National minimum term and condition document.

Guidelines manuals.

Education on the different types of employment (employee, contractor etc)... before the GPT3 match...

Knowing what peers have negotiated.

Minimal term and condition for GPT3.

Average percentage billings per annum for each area.

An idea of what other Registrars are earning.

Experience and formal documents.

Guide with special skills.

Personal advice.

Acceptance of NMTC by practices.

GPT3 Registrars: • • • •

Training to the RLOs so they can disseminate to the supervisors what is and isn't acceptable.

Negotiating guidelines manual; recommended contract with guidelines.

An idea of what aspects are negotiable and framework of what is considered reasonable.

Good knowledge/advice about taxation laws.

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• • • • • • • • • • • • • • • • • • •

Sample dialogues on negotiating terms and conditions.

Workshop and recommended contract.

Negotiating guidelines.

Research on percentages for contractors in cities.

Generally no negotiating power as Registrar.

Template for ideal terms and conditions (vs. minimum terms and conditions).

Knowing what is normal.

‘Future Series’-type teaching, state-based.

What market rates are to assist us in a reasonable percentage to ask for.

Know how much other Registrars earn.

Guidelines on how to negotiate. How NMTC fits with the new national award for all doctors.

List of important things to ask/look for when negotiating a contract.

Course such as "getting to yes".

The employer actually talking to me; mine wouldn't communicate at all (corporate practice). It was take it or leave it at NMTC so a NMTC for GPT3 would be useful.

More workshops and practice.

Maybe in GPT3 negotiations that a facilitator could sit in on negotiations and help prompt Registrars or support them so as to feel more confident.

An idea of usual conditions for GP graduates.

Provide access to a good accountant.

If GPT3 Registrars consent (of course anonymously), they can provide examples of negotiated contracts, and show the variety possible.

Extended skills/Special skills Registrars: • • • • • • • •

• • • •

Recommended contract guidelines.

Would love them to continue on with ‘Future Series’ which has some involvement in that, also clearer links on website or a website or memory stick with resources.

Most especially the latter [recommended contract with guidelines] - can be given to the employers...

Not sure.

Comparative figures with different RTPs. Skill comes with exposure to different practice. I think this is a skill which nobody could teach anyone but some example or sample contracts are always handy.

Knowledge of what other practices are offering - a pooled guide that outlines contracts GP Registrars have successfully negotiated at different practices.

I think for indigenous health posts it would be useful to know the average that Registrars in private GP get paid so that appropriate pay salaries can be negotiated (as billings are often so low that a % is of no use so Registrars at risk of being paid much lower wage than colleagues).

More transparency with practice management cost and what we should expect is fair to ask our employees to pay us.

Examples of recommended contracts; a manual on negotiating contracts.

A suggested percentage, minimum terms and conditions.

Minimum terms and conditions document for GPT3 and 4/extended skills. Advice on current industry standards on employment contracts for GPs, i.e. the going rate for pay and conditions.

ARSP Registrars: • • • • •

Negotiating guidelines.

Some indication of what to aim for.

Mentor availability.

Knowledge of what other GPs are actually getting paid.

Guidelines of what is standard.

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• •

Examples from other practices within the same region.

Minimum terms and conditions applied.

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Appendix E – Aspects of work that are paid by condition employed as Table 34: Aspects of Work that are Paid by Condition Employed As Employee Contractor Yes No Yes No 82.5% 17.5% 29.6% (8) 70.4% a) Sick leave (198) (42) (19) b) Annual leave 88.4% 11.6% 41.4% 58.6% (214) (28) (12) (17) c) Study leave 31.4% 68.6% 8.0% (2) 92.0% (60) (131) (23) d) Maternity/Paternity 19.7% 80.3% 8.3% (2) 91.7% leave (34) (139) (22) e) Carers Leave 41.3% 58.7% 16.0% (4) 84.0% (76) (108) (21) f) Public holidays 67.7% 32.3% 26.9% (7) 73.1% (149) (71) (19) g) Superannuation 95.3% 4.7% 42.3% 57.7% (221) (11) (11) (15) h) SIPS (maybe a 47.1% 52.9% 69.6% 30.4% (7) portion of this) (90) (101) (16) i) PIPS (maybe a 38.3% 61.7% 40.9% (9) 59.1% portion of this) (70) (113) (13)

Both Yes No 61.5% (8) 38.5% (5) 61.5% (8) 38.5% (5) 23.1% (3) 76.9% (10) 18.2% (2) 81.8% (9) 25.0% (3) 75.0% (9) 58.3% (7) 41.7% (5) 76.9% 23.1% (10) (3) 54.5% (6) 45.5% (5) 54.5% (6) 45.5% (5)

Q48. The following aspects of my work are paid… Base: All Respondents (n=133 respondents did not answer this question at all)

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