The Royal Australian College Of General Practitioners is the professional body for General Practitioners in Australia.
The Royal Australian College of General Practitioners is responsible for maintaining standards for quality clinical practice, education and training, and research in Australian general practice. The RACGP has the largest general practitioner membership of any medical organisation in Australia, with the majority of Australia's general practitioners belonging to their professional college. Over 22,000 general practitioners are members of the RACGP Continuing Professional Development Program. The RACGP National Rural Faculty, representing more than 5000 members, has the largest rural general practitioner membership of any medical organisation in Australia.
Prior to the mid 20th century, upon graduation Australian doctors spent time in general practice. The common passage of a medical career comprised of most doctors completing an intern year immediately post graduation as a resident in a major teaching hospital. After a period of time in general practice, some doctors would seek specialist qualifications. Possibly reflecting the historical origins of Australia as a series of British colonies, these doctors would travel overseas, most often to the UK, to specialise and then return to establish practice.[1]
As the Australian population grew post World War II, the public hospital system also grew demanding an increasing number of specialists. Local training program emerged and therefore the ability of a doctor to enter specialist training directly following the mandatory intern year post graduation without entering general practice. This increasing number of specialist made it increasingly difficult to general practitioners in Australia to hold and retain public hospital appointments, especially in procedural areas such as surgery or obstetrics.
This was not a uniquely Australian phenomenon. Worldwide, medical practice was shifting focus onto hospitals with the expansion of pharmaceuticals and medical and surgical interventions. In the United States, the number of doctors identifying as General Practitioners fell markedly between 1931 and 1974 from 83% to 18%. This process began as specialisation increased prior to the War. US GPs increasingly felt that health care was becoming fragmented and weakening doctor patient relationships.[2]
“There are 57 different varieties of specialist to diagnose and treat 57 different varieties of disease but no physician to take care of the patient."[3]
This led to the creation of the American Academy of General Practice (later Family Physicians) in 1947.
Similarly, in the UK, the increasing specialisation and cost of healthcare, saw the introduction of the National Health Service (NHS), designed to have GPs act as the ‘gatekeepers’ providing primary care to all patients registered on their ‘list’ and referring as appropriate to gain access to specialist care and other benefits under the UK’s socialised heath system.[4] The UK experience is notably through the contribution and involvement of many influential and effective Australians in defining the problems of general practice and the need for a professional and academic basis to the craft group.
In 1950, an Australian Graduate, Dr Joseph Collings, conducted a review of general practice in the UK. This 30 page report was published in the Lancet in 1950.[5]
“There are no real standards for general practice. What a doctor does and how he does it depends entirely on his own conscience” Dr Collings, 1950.[6]
Dr Collings’ report was scathing and generated immediate and heated interest. It was undoubtably a key event in the definition of general practice as a speciality.[7]
He identified that general practice has no academic underpinning, no evidence upon which to base practice and no consistency of practice. The report did not pull punches. He described rural practice is “an anachronism”, suburban practice is a “casualty-clearing” service and Inner city practice is “at best… very unsatisfactory and at worst a positive source of public danger.”[8] [9]
There is a direct link between the public criticism of general practice and the move to create a College. Dr Rose and Dr Hunt in the BMJ 1950 write:
“There is a College of Physicians, a College of Surgeons, a College of Obstetricians and Gynaecologists, a College of Nursing, a College of Midwives and a college of Veterinary Surgeons, all of them Royal Colleges; there is a College of Speech Therapists and a College of Physical Education, but there is no college or academic body to represent primarily the interests of the largest group of medical personnel in this country – the 20,000 general practitioners.” [10]
Interestingly, there was opposition in the UK to the creation of a College by the existing three Medical Colleges – Colleges of Surgeons, Physicians and Obstetricians and Gynaecologists – who held the belief that general practice should be a joint faculty of general practice linked to the existing Colleges.[11] However, put into perspective, in the same document Hunt describes the two original British Colleges sought to stop the creation of the College of Obstetricians and Gynaecologists via legal action in 1929.
The British College of General Practitioners was formed in 1953 with many Australian doctors amongst the founding members including the RACGP’s first president Dr William Connelly. Dr Connelly, again reflecting the origins of Australia as a series of British colonies, established a New South Wales faculty of the BCGP. This was followed by the creation of other state based faculties of the British College of General Practitioners in Queensland, Western Australia, Tasmania, Victoria and South Australia over the next 5 years.
In keeping with the process for creating Medical Colleges under the British system, a group of Australian General Practitioners met in 1957 at the first Annual Scientific Convention in Sydney to declare an intention to form the Australian College of General Practitioners (ACGP) which was formally founded in 1958. This new College joined the state based faculties. State based faculties remain a key part of the modern day function of the RACGP.
This College established the following objectives:
- To promote a scientific approach to problems of disease at the level of the individual and the family;
- To promote the prevention of disease and guard the nation’s health and the welfare of the community by every means available to the general practitioner;
- To foster and maintain high standards of general practice;
- To encourage and assist young men and women in preparing for, qualifying in and establishing themselves in general practice;
- To stimulate postgraduate education of general practitioners by providing facilities applicable to general practice; and
- To conduct clinical research into conditions most frequently seen and appropriately studied in general practice.[12]
In modern Australia, General Practice is listed by the AMC as a medical specialty and the RACGP as the specialist college responsible for assessment.[13] Yet, on further examination of how general practice is considered across the nation, some State-based Medical Practitioners’ Boards such as Victoria, Queensland and South Australia, do not consider general practice a medical specialty and general practice qualifications, such as the Fellowship of the Royal Australian College of General Practitioners (FRACGP) are not registrable qualifications.
The oddity of general practice in Australia is a lingering and arguably outdated perception that the decision to practise as a GP has low or no standing and status. Comments heard by many GPs including; ‘You are just a GP’ or ‘What do you intend on specialising in?’ reflect something of the community understanding of the General Practitioner.
This is not without precedent. The history of the General Practitioner shows that GPs in early Australia through to GPs in mid and late 20th century, ‘defaulted’ into general practice having disliked surgical or physician training or having failed exit exams too often.[14]
Also, while Australian General Practitioners were part of the creation of the Royal College of General Practitioners and instrumental in highlighting the need for professional and practice standards, Australia was one of the last developed countries to recognise general practice as a specialty. It was 1978 before the National Specialist Qualification Advisory Committee (the predecessor to the Australian Medical Council) recognised general practice as a specialty.[15] In contrast, The United Kingdom had a powerful case for recognition by the late 1960s, and the United States recognised general practice in 1969.[16][17]
The standing of general practice within academic faculties of universities and professionally has undergone a marked increase in recent decades. The RACGP has been a key driver of this shift. The development and consolidation of training programs, standards for training, standards for practice, curriculum of general practice and various evidence based guidelines and publications have occurred internally within the College.[18] Outside of the College there are a few important events:
Demonstrating again the slow shift towards recognition, Australia was late in accepting that general practice should be taught or regarded as a discipline in its own right. The Whitlam government’s Karmel committee into ‘Expansion of Medical Education in Australia’ compromised with departments of ‘community medicine’ – a confusing anachronism that persisted for many years in Australia’s tertiary institutions.[19] The RACGP sought strongly but unsuccessfully that this committee accept general practice into the universities.
Today, general practice is listed or has been added along side community medicine, highlighting the shift since the early 1970s (eg Department of General Practice and Community Medicine Monash University)[20]
Nine foundation professors of ‘Community Practice’ were appointed between 1974 and 1976. Again Australia lagged behind the US and the UK who appointed their first professors and Chairs of general practice and family medicine in 1967 and 1963 respectively.[21]
The Foundation professors were:
Notably, many did not hold general practice qualifications either from Australia or international.
The definitive point in Australian General Practice came with John Murtagh's General Practice. [23]
John Murtagh was a science teacher in rural Victoria who return to study Medicine at the first intake of Monash University. John Murtagh has along academic association through Monash University becoming the first Professor of General Practice (Neil Carson was Professor of Community Medicine). He remains with teaching positions at Monash University as Professor in General Practice, University of Notre Dame as Adjunct Clinical Professor and Melbourne University as Professorial Fellow.
He was associate medical editor of the Australian Family Physician (the RACGP peer reviewed journal) in 1980, editor in 1986 and held that position until 1995. He began the popular CHECK (Continuous Home Evaluation of Clinical Knowledge), he also held the position of Executive Director of Training at the RACGP at the turn of the 21st century. The RACGP library is named after John Murtagh.[24], offering a wide range of services to Members, registrars and all health professionals working in Aboriginal and Torres Strait Islander Community Controlled Health Services.[25]
'To add a library to a house is to give that house a soul' - Professor Michael Kidd, RACGP President 2002-2006 quoting Cicero 1st December 2005
His companion publication Practice Tips was named as the British Medical Association's Best Primary Care Book Award in 2005. He received a Member of the Order of Australia for service to medicine, in particular, medical education, research and publishing.
Past Presidents of the RACGP[26] | Date |
---|---|
WA Connelly | 20th March 1959 - 28th October 1961 |
HS Patterson | 28th October 1961 - 24th October 1963 |
CW Anderson | 24th October 1963 - 27th October 1966 |
CC Jungfer | 27th October 1966 - 10th October 1968 |
MO Kent Hughes | 10th October 1968 - 15th October 1970 |
HN Merrington | 15th October 1970 - 5th October 1972 |
JG Radford | 5th October 1972 - 3rd October 1974 |
DA Game | 3rd October 1974 - 25th August 1976 |
JRH Watson | 25th August 1976 - 25th October 1978 |
WD Jackson | 25th October 1978 - 12th August 1980 |
KWK Shaw | 12th August 1980 - 18th October 1982 |
RT Finch | 18th October 1982 - 5th September 1984 |
DP Finegan | 5th Spetember 1984 - 20th October 1986 |
AE Fisher | 20th October 1986 - 8th September 1988 |
GR Gates | 8th September 1988 - 28th Spetember 1990 |
AR Buhagiar | 28th September 1990 - 24th September 1992 |
P Stone | 24th September 1992 - 15th September 1994 |
CE Owen | 15th Spetember 1994 - 16th October 1996 |
P Joseph | 16th October 1996 - 15th October 1998 |
M Kilmartin | 15th October 1998 - 11th October 2000 |
P Hemming | 11th October 2000 - 8th October 2002 |
M Kidd | 8th October 2002 - 30th September 2004 |
M Kidd | 30th September 2004 - 5th October 2006 |
Past Chair of Council[27] | Date |
---|---|
WA Connelly | 7th March 1958 - 30th September 1959 |
Sir Leonard Mallen | 30th September 1959 - 20th October 1962 |
D Zacharin | 20th October 1962 - 23rd October 1965 |
HM Saxby | 23rd October 1965 - 29th October 1966 |
HRN Oaten | 29th October 1966 - 9th October 1969 |
DA Game | 9th October 1969 - 25th November 1972 |
MS Cooling | 25th November 1972 - 16th October 1975 |
WD Jackson | 16th October 1975 - 25th October 1978 |
GR Gates | 25th October 1978 - 17th October 1981 |
GM Dick | 17th October 1981 - 5th September 1984 |
GC Miller | 5th September 1984 - 26th July 1986 |
JC Bampton | 26th July 1986 - 2nd September 1987 |
KP Mahoney | 2nd September 1987 - 29th September 1990 |
RJ Mecoy | 29th September 1990 - 25th September 1992 |
GD Martin | 25th September 1992 - 6th October 1993 |
RC Gutch | 6th October 1993 - 15th September 1994 |
JW Turnbull | 15th September 1994 - 16th October 1996 |
JH Summons | 16th October 1996 - 26th October 1999 |
P Clyne | 30th October 1999 - 27th October 2001 |
P Hemming | 27th October 2001 - 8th October 2002 |
C Jackson | 8th October 2002 - 8th October 2003 |
L Rowe | 8th October 2003 - 30th September 2004 |
P Mudge | 30th September 2004 - 5th October 2006 |
Life Fellow of the RACGP[28] | Date of award |
---|---|
William Arnold Connelly | 20th February 1981 |
H Stuart Patterson | 18th September 1985 |
Colin Warden Anderson | 2nd September 1987 |
Herbert Ewan Hamilton Ferguson | 2nd September 1987 |
Harvard Northcroft Merrington | 8th September 1988 |
John Goulburn Radford | 8th September 1988 |
Rollo Greenless | 28th September 1989 |
Bernard Selwyn Alderson | 24th September 1992 |
William Desmond Jackson | 15th September 1994 |
John Charles Bampton | 16th October 1996 |
David Sunter Muecke | 16th October 1996 |
William Francis Glastonbury | 30th September 1997 |
David Game | 15th October 1998 |
Edgar John Hamilton North | 26th October 1999 |
Richard Geeves | 8th October 2003 |
Wesley Fabb | 8th October 2003 |
Peter Doyle | 8th October 2003 |
Charles Bridges-Webb | 30th September 2004 |
Neil Carson | 30th September 2004 |
Max Kamien | 30th September 2004 |
Jack Marshal | 30th September 2004 |
James Colquhoun | 30th September 2004 |
Clive Oswald Auricht | 29th September 2005 |
Mary Deidre Mahoney | 29th September 2005 |
John Alfred Stevens | 29th September 2005 |
Alan (Eric) Fisher | 5th October 2006 |
Richard (Dick) Gutch | 5th October 2006 |
Bruce Roberts | 5th October 2006 |
Elizabeth Jane | 5th October 2006 |
Honorary Fellow of the RACGP[29] | Date of award |
---|---|
Lord Hunt of Fawley | 20th March 1959 |
Ian Grant | 20th March 1959 |
William Pickles | 20th March 1959 |
The Honourable Donald A Cameron | 19th October 1962 |
Sir Theodore Fox | 19th October 1962 |
Robert John Francis Homfrey Pinsent | 24th October 1963 |
Henry Edward Martyn Williams | 24th October 1963 |
William Victor Marcus Coppleson | 24th October 1963 |
The Right Honourable Sir Robert Gordon Menzies | 9th October 1964 |
Sir Lorimer Fenton Dodds | 22nd October 1965 |
Carroll L Witten | 29th May 1966 |
James T McCollough | 29th May 1966 |
Sir Norman Nock | 11th October 1967 |
Sir Thoman Moore Greenway | 1st July 1968 |
Bruce Toomba Mayes | 10th October 1968 |
Douglas Gordon | 10th October 1968 |
George Ian Watson | 2nd September 1972 |
James Lester Grobe | 2nd September 1972 |
Claude Howard Murphy | 2nd September 1972 |
Ronald Diarmid MacDiarmid | 2nd September 1972 |
Donald Ingram Rice | 2nd September 1972 |
Prakash Chand Bhatla | 2nd September 1972 |
Bratham Ramaswarmy Sreenivasan | 26th November 1972 |
His Royal Highness, Prince Philip, The Duke of Edinburgh | 24th January 1973 |
Wong Heck Sing | 25th August 1975 |
Sir Keith Stephen Jones | 15th October 1975 |
Selwyn Carson | 25th October 1978 |
James Rupert Magarey | 25th October 1978 |
David Clements Jackson | 18th October 1982 |
John George H Refshauge | 11th October 1984 |
Yvonne Sinclair | 19th April 1986 |
Reginald Lewis Perkin | 2nd September 1987 |
Bertram Herries Young | 2nd September 1987 |
Victor William Michael Drury | 8th September 1988 |
Barry Betham Grimmond | 8th September 1988 |
Thomas Smith Reeva | 8th September 1988 |
Edward Bassett | 28th September 1989 |
Robert Edward McKeown | 28th September 1989 |
Ronnie Woh Mun Yeun | 28th September 1989 |
Raymond George Ross Moon | 28th September 1990 |
Peter Erne Baume | 26th September 1991 |
Manacadu Kumar Rajakumer | 24th September 1992 |
Peter George Flemming | 6th October 1993 |
Frank Fry | 15th September 1994 |
John Derek Richardson | 15th September 1994 |
Peter CY Lee | 15th September 1994 |
Neil Blewett | 15th September 1994 |
Trevor Corey Beard | 28th September 1995 |
Patrick Augustus Simon Edmonds | 16th October 1996 |
Sir Gustav Joseph Victor Nossal | 15th October 1998 |
Goh Lee Gan | 8th October 2003 |
Theres (Tessa) Turnbull | 8th October 2003 |
W Bruce Connelly | 8th October 2003 |
Michael Boland | 30th September 2004 |
Stephen Foo | 30th September 2004 |
Nat Yuen | 30th September 2004 |
Fiona Stanley | 30th September 2004 |
Ngaire Joy Brown | 29th September 2005 |
Donald Kwok Tung Li | 29th September 2005 |
Ruby Binti Adbul Majeed | 29th September 2005 |
Helen Wilhelmina Rodenberg | 29th September 2005 |
Bruce Louis Walsh sparks | 29th September 2005 |
Geoffrey Henry James Vause | 29th September 2005 |
Ian Frazer | 5th October 2006 |
William Glasson | 5th October 2006 |
Alfred W T Loh | 5th October 2006 |
Roger Neighbour | 5th October 2006 |
Daniel Maheridran Thuraiappah | 5th October 2006 |
Honorary Member of the RACGP[30] | Date of award |
---|---|
Reginald Gilbert Hayward | 24th October 1963 |
James Robert Clough | 11th October 1967 |
Robert Spence | 10th October 1968 |
Maxwell Stanley Jarvis | 9th October 1969 |
Adrian William Helm | 21st October 1971 |
Dorothy Francis Bird | 2nd September 1972 |
Jon Allen Baker | 25th October 1978 |
Helena Christine Britt | 28th September 1995 |
Glenda May Williams | 28th September 1995 |
Ilse Quantrell | 20th September 1997 |
Ann Dooley | 15th October 1998 |
Ronald Rees | 26th April 1999 |
Lillace Mary Burrow | 12th August 2000 |
Joan Bruton | 30th September 2001 |
Patricia Ritchie | 30th September 2001 |
Judith Tuner | 30th September 2001 |
Rod Wellard | 8th October 2003 |
Margaret Gore | 8th October 2003 |
Prue Power | 8th October 2003 |
Pam Garrard | 30th September 2004 |
Moni Lobascher | 30th September 2004 |
Jane Ryan | 30th September 2004 |
Sue Whicker | 30th September 2004 |
Annette Young | 30th September 2004 |
Robyn Ellen Cronnolly | 29th September 2005 |
Carol Mary Elliott | 29th September 2005 |
Marian Diesner | 29th September 2005 |
Fidelis Leong | 29th September 2005 |
Glenda Joy Malkin | 29th September 2005 |
Neil Greenway | 5th October 2006 |
Robin Toohey | 5th October 2006 |
Sharon Butler | 5th October 2006 |
Lucy Di Natale | 5th October 2006 |
Amy Jasper | 5th October 2006 |
Julie Lam | 5th October 2006 |
Diane Schaefer | 5th October 2006 |
Mary Martin | 5th October 2006 |
Ian Dingwall Grant
Joseph Silver Collings
Kenneth Macd Foster
Gilbert S McDonald
Sir Theodore Fox
William Victor Johnston
Sir Clive Hamilton Fitts
Trevor Corey Beard
Carroll Lewis Witten
Bruce Toomba Mayes
Richard Roderick Andrew
Geoffrey Malcolm Badger
HRH Prince Philip, The Duke of Edinburgh[31]
Sir Kenneth Beeson Noad
Professor Eric Galton Saint
Prakash Chand Bhatla
Sir Mark Oliphant
Geoffrey C Bolton
David C Jackson
Sir Stanley Burbury
Sir Edward Hughes
Senator Peter Baume
Justice Kemeri Murray
Professor David Maddison
Stuart Patterson
Sir Ninian Stephen
The Most Reverend Dr Peter Carnley
Associate Professor Byan Gandevia
Ms Katherine West
Professor Stephen Leeder
Professor Ralph Doherty
not held
Dr Keith Bolden
Professor Max Charlesworth
The Most Reverend Dr Keith Rayner
Dr William Faulding Scammell CBE
Professor Richard Smallwood
Associate Professor David Bennett
Dr Reg L Perkin
Dr John Stevens
Emeritus Profesor Neil Carson
Dr David A Game
Professor Dame Lesley Southgate DBE
Professor W Bruce Connolly
Professor Judith Belle Brown
Professor Wesley Fabb AM
Professor Max Kamien AM
Dr Ngaire Brown
Professor Ian Frazer[32]
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