GP Prior Approval Form

GP Prior Approval Form

GP training can accrue a maximum of six months FTE non-ED training time in Advanced Training
Name*

TitleFirst NameLast Name
Email*
example@example.com
ACEM ID*
Placement*
What FTE are you working during this period?*
Site Name*
Site Address*

Street Address

Street Address Line 2

CityState

Post Code
Region training provider *

Supervisor Details
Name*

TitleFirst NameLast Name
Email*
example@example.com
Phone Number*
AHPRA/MCNZ number*
Please attach a statement from the Principal GP Supervisor.

This statement must:
- Be provided on practice letterhead.
- Be signed by the author.
- And detail the following:
  - The start and end date of the placement.
  - What FTE the placement will be undertaken at.
  - Confirmation from the supervisor that they will be responsible for your supervision and the completion of ITA’s (supervision must be direct and for the whole period).
Attach Statement*

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Please attach a full job description for the post*

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Please attach a certified copy of the certificate/letter from the relevant College (on that body’s letterhead) which certifies that the practice is accredited for GP registrar training and confirms the dates that the accreditation is valid for.*

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Reminder to Trainees
B2.3.2.2 Trainees who are ‘time-complete’ must, during each subsequent 12 calendar month period, commencing from the date on which they become ‘time-complete’:

(a) complete at least three (3) FTE months continuous training in an accredited emergency medicine placement;

(b) complete appropriately accredited/approved training placements during the remaining nine (9) months of each such period; and

(c) satisfactorily complete all assessment and review requirements associated with these placements.
If you have any questions about this GP application or are concerned about meeting training requirements, please contact training@acem.org.au or on +61 3 9320 0444.
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Supervisor Details