GP surgeons: what are they? An audit of GP surgeons in South Australia

Abstract

INTRODUCTION: In many parts of Australia where there is no access to local specialist services, procedural services are provided by local GPs. Within the range of procedural skills offered, a small group of GPs is able to provide surgery. Unlike other procedural areas, there remains no defined training or assessment pathway for GP surgeons. Support from specialist colleagues is variable and continuing education arbitrary. The result is a somewhat ill-defined group that is poorly understood by credentialing bodies, government, medical defence organisations and training colleges. This study aims to describe the scope of practice, initial training and ongoing support and education for GP surgeons currently practising in South Australia. METHODS: Seventeen semistructured interviews were undertaken with self-identified GP surgeons (74% response rate). Areas explored included demographics, scope of practice, initial training and ongoing support and education. Content and thematic analysis was used to identify common responses and themes. RESULTS: The amount of initial training varied among participants, with a mean duration of training of 20 months. Initial assessment of competency for the majority of participants was assessment by a supervisor (10/17). The most common procedures undertaken were caesarean sections (94% of participants) and grafts and flaps (94%). The most common continuing professional development was clinical attachments (27%) and assisting visiting specialists or colleagues (17%). CONCLUSIONS: This study demonstrates a wide variation in training, scope of practice and continuing education for GPs performing surgery, highlighting the effects of a self-regulated system. There is a trend towards an increased level of training; however, engagement in continuing education remains low. Further work is needed to define this group, to enable successful planning of future training and education to support this group in rural areas.