Evidence from the GP Synergy NSW & ACT Research and Evaluation Unit – each month we present findings from our work that may be of interest to registrars and their supervisors.
GPs play a vital part in diagnosis and ongoing management of pregnancies in Australia. Some GP registrars entering GP training may have had no post‐graduate experience in obstetrics and gynaecology. Working with an academic GP registrar from General Practice Training Queensland/The University of Queensland, we aimed to use ReCEnT data to determine the prevalence and associations of Australian GP registrars’ clinical consultations involving antenatal care.1
We found that antenatal care comprised 1.1% of registrar problems/diagnoses. Registrars seeing pregnancy‐related presentations were more likely to be female, in term three, younger, and to have post‐graduate qualifications in obstetrics and gynaecology. They were also more likely to be practising in lower socioeconomic areas
Patients presenting for pregnancy-related consultations were more likely to be from a non‐English speaking background.
Pregnancy‐related consultations were, on average, of longer duration than other consultation.
Registrars were less likely to generate learning goals in pregnancy-related consultations.
The findings tell us that GP registrars see fewer antenatal problems compared to established GPs. Male registrars, especially, have significantly less exposure to antenatal care, suggesting potential limitation of opportunity to gain skills and experience in antenatal care. There may be scope to increase overall registrar exposure to antenatal care experience and to address the gender imbalance via structural measures in practices’ patient appointment systems or via alternative education, for example, programs providing experience as supernumeraries in obstetrics clinics, or completion of antenatal shared care courses.
GP Synergy registrars will cover antenatal care in their education program. Most HealthPathways have excellent guidelines on antenatal care and protocols in the local area. The Department of Health also has an excellent resource Clinical Practice Guidelines: Pregnancy care.
1Pappalardo E, Magin P, Tapley A, Davey A, Holliday E, Ball J, Spike N, FitzGerald K, Morgan S, van Driel M. General practice registrars’ experience of antenatal care – prevalence and associations: a cross-sectional analysis. 2020. Australian and New Zealand Journal of Obstetrics and Gynaecology. 60(2): 188-295. DOI: 10.1111/ajo.13042
The paper abstract can be found at Australian and New Zealand Journal of Obstetrics and Gynaecology.
If you would like to discuss or read the full-text article, contact Parker Magin.