General practice: Specialty Training Interview Questions Australia

Why general practice, and why rural and remote practice in particular?

Why general practice in terms of the work: continuity, the whole person, the community. Why rural: the breadth, the scope, the relationship with the town, what you have seen. Evidence of rural connection or experience if you have it.

What experience have you had of rural communities, and what did it teach you about practising there?

Specific: where, how long, what you did, and what you learned about rural practice that you did not expect. If your experience is limited, say so and say what you have done to find out.

What do you understand by the scope of a rural generalist, and which advanced skills interest you?

The scope: general practice plus emergency, hospital inpatients, obstetrics or anaesthetics or another advanced skill, in a small hospital and clinic. The skill you would choose and why, in terms of what rural communities need. Say what you have seen of the scope in practice.

What do you know about the ACRRM fellowship programme and its assessments?

The structure, the assessments, the advanced skills training, the rural requirements and the supervision. Two accurate sentences, then what will be hardest.

How will you and your family manage living and working in a small community?

Honestly: the partner's work, the children's schooling, distance from family, the social life of a small town, and what you have discussed. The panel is selecting for people who will stay and they have seen the family question end careers.

A patient in a small town is also your neighbour and asks about another patient's results. How do you handle it?

Decline warmly and without awkwardness: you cannot discuss anyone's care, you would not discuss theirs, and they can ask the person directly. Reflect that protecting confidentiality in a small town is how the doctor stays trusted by everyone.

Tell us about a time you explained a difficult diagnosis to a patient with low health literacy.

One real conversation: what the person needed, plain words, one message at a time, teach back, written material, and the follow up. What was hard and what you would do differently.

How do you work with an Aboriginal health worker to provide care in a remote community?

As a colleague with knowledge you lack: the community, the families, the history, the language, what will and will not work. Share the plan, ask their view, act on it, and credit it. One example if you have one.

A patient is angry because they waited two hours. Speak to them.

Acknowledge first and genuinely, listen to the whole complaint, explain without defending, say what you will do now, and offer the practice's complaints process. De escalation is the mark, not winning.

You are the only doctor in town and a close friend asks you to be their GP. What do you do?

Explain the conflict: objectivity, the friend's ability to tell you things, your ability to refuse a request. The options: a doctor in the next town, telehealth with a GP elsewhere, or if there is truly no alternative, explicit boundaries, careful documentation and another doctor for anything sensitive. The answer that fails refuses without acknowledging the problem or agrees without naming it.

A patient asks for a medical certificate for days they were not sick. What do you do?

Certify what you can verify and nothing else. Explain why, kindly, offer what you can honestly provide, and keep the relationship. Say what you would do if the patient pushed.

A patient tells you they are driving despite seizures. What are your obligations?

Explain the law and the medical standards for driving, the patient's responsibility to notify the licensing authority, and your own obligations in your state, which may include notifying the authority yourself. Give the patient the chance to act first, document, and say what you would do if they refused.

What does cultural safety mean in a community where most of your patients are Aboriginal?

Defined by the patient: care that the community experiences as safe and respectful. Your actions: working with the Aboriginal health workers and the community controlled service, learning the community's history and protocols, family in decisions, flexibility, and the humility to ask rather than assume. One example if you have one.

A 55 year old farmer presents to your rural emergency department with chest pain and ST elevation. The nearest cath lab is three hours away. What do you do?

Thrombolysis when primary intervention is out of reach, with the state's cardiac advisory line on the phone; aspirin and the second antiplatelet, analgesia, monitoring, and the retrieval service called early. Say what would exclude thrombolysis and what you would do during the three hours.

A child with a fever and a rash is brought to the clinic in a remote town. How do you assess and manage them, and when do you retrieve?

The sepsis assessment of a child: the observations, the capillary refill, the rash, the fontanelle. Antibiotics now at the weight based dose if sepsis is possible, fluids by weight, the paediatric advisory line and retrieval called early, and the family and the Aboriginal health worker involved. Say what would make you retrieve rather than observe.

A woman at 36 weeks presents with abdominal pain and bleeding in a town with no obstetric service. What do you do?

Placental abruption or praevia until proven otherwise: resuscitate, no vaginal examination, bloods and crossmatch, the obstetric advisory line and retrieval now, steroids for the baby, and prepare for delivery and haemorrhage if the baby comes before the team. Say what you would tell the woman.

A 70 year old with diabetes, heart failure and kidney disease comes for a review. How do you prioritise and plan their care?

Find out what matters to the patient, prioritise, use a care plan and the team, coordinate the specialists by telehealth, address the practical barriers of distance and cost, and agree a review. Say how you would avoid the plan collapsing under its own weight.

A patient presents with low mood and says they have been thinking of ending their life. How do you assess and manage them?

Safety first, then the risk assessment: intent, plans, means, risk factors, protective factors, collateral. The decision: local management with a safety plan and close follow up, or transfer to a mental health unit with the advisory line and retrieval involved, voluntary or under the legislation. Say how you would keep the patient safe during the wait and who in the community could help.

A motor vehicle accident occurs on the highway near your town. How do you prepare and manage the first hour?

Activate the local emergency plan, call ambulance, retrieval and police, prepare the hospital with the staff you can muster, triage on arrival, treat the most urgent survivable injuries, and keep a record. Say what you would do about your own limits and the staff afterwards.

What are the main health challenges facing rural and remote Australians?

Distance and access, workforce, chronic disease, mental health, the life expectancy gap for Aboriginal and Torres Strait Islander people, and the cost of care. Say what a rural GP can do about one of them.

How do Medicare, bulk billing and practice incentives shape general practice?

Medicare rebates fund consultations, bulk billing incentives shape who can afford care, the practice incentive payments reward chronic disease management and other priorities, and the mix shapes how a practice runs and what it can offer. Say how it affects rural practice in particular.