Interest in general practice and rural generalism as specialties has continued to grow over successive years.
Specialist non-GP trainees were considerably more likely than GPs-in-training to experience or witness discrimination and racism from colleagues and senior staff, according to this year’s Medical Training Survey.
The yearly report, which was released by AHPRA on Tuesday, captured responses from more than 17,500 interns, prevocational trainees, specialist trainees and international medical graduates working in Australia.
This year’s edition tells two important stories about general practice training.
The first of those is that interest in GP and rural generalist training is continuing to grow.
Around 11% of interns plan to go into RACGP training, while another 4% plan to pursue an ACRRM fellowship.
Put together, the proportion of interns intending to become GPs outweighs that of every other specialty bar internal medicine.
Last year, general practice training was tied with internal medicine training at 17% (RACGP and ACRRM together) in terms of popularity among interns.
There’s a slightly different pattern among prevocational and unaccredited trainees, 18% of whom are interested in pursuing an RACGP fellowship and 3% of whom intend to pursue an ACRRM fellowship.
Surgery training is the next-most popular option after RACGP fellowship, followed by anaesthesia and emergency medicine.
General Practice Supervision Australia chair Dr Candice Baker told The Medical Republic that while face-to-face teaching time was remunerated within the GP training space, clinical supervision was not.
This holds not just for GP registrars, but also for medical students and prevocational doctors undertaking GP placements.
“[Clinical supervision] is really where all the growth happens within general practice training and in that interaction with your registrar,” she said.
“Is the system set up and ready to go? I suspect the answer is probably no, that there needs to be a real uplift and a real support of that clinical supervision. … The whole system is built on this model, and we need our supervisors on the ground to be able to achieve that with an increased number of trainees.”
In order to absorb the amount of increased learners entering general practice and rural generalism over the next few years, Dr Baker said the sector will need “a bigger look and some clever ideas”.
The second key takeaway on general practice from the 2025 Medical Training Survey was that fewer GP trainees experienced or witnessed bullying, harassment, discrimination or racism compared to their hospital-trained counterparts.
According to the doctor in training cohort report for non-GP specialist trainees, one quarter of registrars had experienced harassment, discrimination or racism, while 34% had witnessed at least one of these behaviours in their workplace.
Bullying was the most common form of unacceptable behaviour witnessed or experienced by non-GP specialist registrars.
More than half of the non-GP specialist registrar respondents said this behaviour had come from a senior medical staff member, one third said it had come from a nurse or midwife and around one quarter said it had come from another registrar or doctor-in-training.
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Around 46% of respondents said they had experienced bullying or harassment from a patient or carer.
Among specialist GP trainees, just 15% said they had experienced any form of bullying, harassment, discrimination or racism in the workplace, while 16% said they had witnessed it.
Bullying was tied with racism as the most common form of unacceptable behaviour seen or experienced by GPs-in-training.
When it came to perpetrators, one third of GP trainees said this behaviour had come from senior medical staff, one in five said it had come from a nurse or midwife and one in six said it had come from another registrar or doctor-in-training.
Dr Baker credited the smaller, community-based nature of GP training for the difference in training environment.
“I think within that space general practices tend to have fewer staff than in hospital settings,” she said.
“There are often closer working relationships and very long-term working relationships that are built within general practice, and I think that fosters that collegiality and some of that accountability as well.
“I think it’s partly where the training happens, but I also think that the relationship between the GP registrar and their supervisor is quite special in general practice.
“There’s a fair percentage of registrars that will do 12 months in their training posts, and so I think we really get that continuity of supervision and that mentorship, which has the flow on effect of creating a more supportive learning environment.”
General Practice Registrars Australia president Dr Chris Dickie told TMR that while it was “encouraging” to see that fewer GP trainees witness or experience unacceptable behaviours, more could be done to improve culture.
“As Australia’s national independent peak voice for future GPs, GPRA always supports the improvement of workplace culture and safety in training,” he said.
Dr Sanjay Hettige, chair of the AMA Council of Doctors in Training, said that Australia risked losing talented doctors due to preventable cultural issues, noting that one in 10 survey respondents were considering leaving medicine within the next year.
Among Aboriginal and Torres Strait Islander respondents, one in six said they were considering leaving medicine.
“These are not just statistics – they represent our future GPs, other specialists and healthcare leaders who are being failed by the system,” Dr Hettige said.
“The AMA is urging governments, health services and training providers to implement comprehensive anti-bullying strategies, manage the risks of fatigue more effectively and invest in robust mental health support systems – which must include committing to the Every Doctor Every Setting Framework and action plan.
“Fear of repercussions remains the primary barrier to reporting incidents, with 52% of trainees citing this as their reason for staying silent.
“Every doctor deserves a psychologically safe workplace. The time for incremental change has passed – we need bold, system-wide reform now.”
