Clinical competence is half of what a PESCI panel assesses. The other half is whether you understand the system a general practitioner works in, because a doctor who manages the chest pain well but does not know how to refer, what the PBS will fund or when a notification is required is not yet safe to work alone. This guide covers the essentials panels expect, in plain words.
Medicare and bulk billing
Medicare is the national insurance scheme that pays a rebate for medical services listed in the Medicare Benefits Schedule, each with an item number. A general practice consultation has item numbers by length and complexity. Bulk billing means the practice accepts the Medicare rebate as full payment and the patient pays nothing; otherwise the practice charges a fee and the patient pays the gap. Incentive payments encourage bulk billing for children, concession card holders and, under recent changes, more broadly. Panels expect you to know what bulk billing is, that item numbers have requirements, and that billing accurately is a professional obligation.
The PBS
The Pharmaceutical Benefits Scheme subsidises listed medicines, with restrictions on some that require the patient to meet criteria, and authority requirements for others that need approval before prescribing. Prescribing outside the PBS is allowed but the patient pays the full cost. Panels expect you to know that the PBS exists, that restricted and authority items need their criteria met, and where to check.
Referral pathways
A general practitioner refers to specialists with a referral letter that carries a Medicare validity period, to public hospital outpatients through the hospital's referral process, and to the emergency department directly or by ambulance for emergencies. Allied health referrals under chronic disease arrangements have their own rules. Panels expect you to know how to get a patient to a specialist, how urgent referrals are flagged, and when the emergency department or an ambulance is the right route.
Notifiable diseases
Each state and territory has a list of conditions that must be notified to the health department, some urgently by phone, with the laboratory notifying some and the doctor others. Panels expect you to know that the list exists, where to find it, and that notification is a legal obligation.
Mandatory reporting
Two kinds. Mandatory reporting of child abuse and neglect under each state's child protection law, with the threshold and the categories differing by state. And mandatory notification to AHPRA about practitioners whose impairment, intoxication, departure from standards or sexual misconduct places the public at risk. Panels expect you to know both exist and to apply the child protection one in a scenario.
Prescription monitoring
Every state has a real time prescription monitoring system for drugs of dependence, which a prescriber must check before prescribing and which shows the patient's history across prescribers. Regulations govern the prescribing of opioids and benzodiazepines, with permits required in some circumstances. Panels test this through the patient asking for a repeat of their oxycodone.
Mental health pathways
The state's mental health services, the crisis line, the community mental health team, the mental health treatment plan under Medicare, and the legislation that allows assessment and treatment without consent when a person is at serious risk. Panels test it through the patient with thoughts of dying.
Family violence
The state's family violence services and pathways, the duty of care to children, and the limits of acting without the patient's consent. Panels test it through the disclosure scenario.
Cultural safety
Care that Aboriginal and Torres Strait Islander patients experience as safe and respectful, the Aboriginal health workers and the community controlled health services, the health assessments and the chronic disease programmes designed for Aboriginal patients, and the humility to ask. Panels expect a newcomer to be honest about what is new and willing to learn.
The emergency arrangements
The ambulance service, the local emergency department, the retrieval service if rural, the poisons information line, the emergency telehealth services, and the practice's own emergency plan and equipment. Panels test it through the collapse in the waiting room and the chest pain.
Learning it
An afternoon with the Medicare, PBS and state health department websites, the practice's own orientation material, and a list of the state's services by name. Then use each term where it belongs in the scenarios: the PBS when you prescribe, the referral pathway when you refer, the monitoring system when the patient asks for oxycodone. Panels score accurate, natural use.