Supervision of junior doctors

At the early registrar level it is expected that a prevocational doctor will have acquired the skills, knowledge and behaviours to competently supervise junior doctors.

This task describes a number of activities, as below, where proficiency should be achievable by the end of PGY3.  The doctor is encouraged to download the key clinical task guidelines and seek the support of his/her supervisor for feedback on performance.

  • Manage/supervise delegated tasks, e.g. review at bedside, depending on course of treatment
  • Assist with queries/procedures
  • Check documentation, e.g. progress notes; clear, correct drug chart
  • Plan discharge arrangements, e.g. home supports, appointments, documents
  • PGY 1
  • PGY 2
  • PGY 3

  • Collaboration and teamwork

    • Establish respectful good working relationships with team members and other healthcare professionals
    • Recognise the roles and responsibilities of other professionals within the healthcare team; respect and listen to their concerns about the patient
  • Communication
    • Accurately document medicine prescription, calculations and administration, using recommended terminology, including symbols and abbreviations
    • Demonstrate high-quality written skills to communicate clinical reasoning, e.g. write case notes legibly, concisely and informatively
    • Attend to clarity, structure and appropriate content for specific correspondence, e.g. handover notes and investigation requests
    • Use electronic resources in patient care, e.g. to obtain results, populate discharge summaries, access medicines information and maintain health records
    • Gather information from a variety of sources and use it to ensure continuity of patient care, e.g. referral letters, case records, test results, electronic information
  • Health advocacy
    • Is courteous and compassionate to all patients, without discrimination, regardless of a patient’s chosen lifestyle, e.g. discuss options, offer choices
    • Recognise the interaction between mental, physical and social wellbeing in relation to health
    • Demonstrate awareness of the cultural diversity and requirements of patients

  • Judgement and clinical decision making

    • Use available evidence effectively and efficiently to inform clinical decision making
    • Use basic algorithms and decision trees to manage common problems
    • Recognise personal limitations and ensure appropriate supervision
  • Leadership and management
    • Respond positively to direction
    • Identify and follow patient care protocols, for example:
  • Medical expertise
  • Professionalism
    • Recognise discrimination, sexual harassment and bullying issues and know the hospital response requirements for such issues
    • Maintain an appropriate standard of professional practice and work within personal capabilities
    • Treat colleagues and other health care workers with respect

  • Scholarship and teaching

    • Assist with training of medical students in clinical examination and simple skills

  • Technical expertise

  • Collaboration and teamwork

    • Support new unit (team) members
    • Collaborate with colleagues to plan and implement work rosters
  • Communication
    • Can explain the common conditions of the unit effectively to patients and undertake informed consent for common elective and emergency conditions
    • Explain clinical reasoning to current health team using concise language and a structured approach
    • Keep patients and significant others informed of management plan progress
  • Health advocacy
    • Identify key issues on which to advocate for the patient to ensure their immediate clinical care and requirements are achieved
    • Recognise health needs of an individual patient beyond their immediate condition

  • Judgement and clinical decision making

    • Review patients on a regular basis and make decisions based on their response to treatment
    • Recognise when advice and guidance is required in development of management plans
  • Leadership and management
    • Accept opportunities for increased autonomy and patient responsibility under direction of supervisor
    • Contribute fully in handover of patients within unit
  • Medical expertise
    • Work within unit-based protocols with regard to pre-operative assessment and care, operative procedures and post-operative care:
      • apply medical knowledge to clinical practice
      • implement and evaluate a management plan relevant to the patient following discussion with a senior clinician
      • identify when patient transfer is required, and manage risks prior to and during patient transfer
      • recognise indications for, and risks of, fluid and electrolyte therapy and blood products
      • provide appropriate aftercare and arrange follow up for common procedures 
      • safely manage anti-coagulant therapy and manage diabetes
      • recognise acute cardiac events and use relevant resuscitation/drug protocols
      • initiate resuscitation of the unwell patient. Recognise indicators for sepsis and implement clinically relevant plan
      • maintain a clinically relevant patient management plan of fluid, electrolyte and blood product use
      • recognise and manage fluid and electrolyte imbalances in a patient
      • effectively use semi-automatic and automatic defibrillators
      • provide appropriate aftercare and arrange follow up for more complex procedures
      • recognise when patients are ready for discharge and arrange referral to relevant members of the healthcare team to promote planning for safe discharge
    • Safely prescribe use of antimicrobials and be aware of the influence of the pharmaceutical industry. Clearly understand proper surgical prophylaxis and distinguish this from therapeutic use of antibiotics for bacterial infections
    • Specify peri-operative management of anticoagulants and antiplatelet agents and recognise prescription and/or administration errors
    • Identify common risks in older and complex patients, e.g. falls risk and cognitive decline
    • Follow-up and interpret investigation results appropriately to guide patient management
  • Professionalism
    • Critically reflect on own performance and make an accurate assessment of this

  • Scholarship and teaching

    • Lead the training of junior doctors in clinical examination and teaching of simple skills using a teaching plan
    • Provide constructive, timely and specific feedback to interns based on observation of a junior’s performance, encouraging them to reflect on their own learning

  • Technical expertise

    • Assist with teaching junior staff

  • Collaboration and teamwork

    • Effectively prioritise patients with multiple medical conditions of varying disease severity
    • Able to coach or supervise juniors, as required by the clinical task
    • Encourage participation of all team members and allocate appropriate tasks to junior members
    • Engage junior doctors, nursing and ancillary staff in ward rounds
  • Communication
    • Set an appropriate tone for any communication with patients and their families, peers and colleagues
    • Collect and collate relevant information from other team members or specialist teams pertinent to decision making or patient management
  • Health advocacy
    • Able to advise on health needs of an individual patient beyond their immediate condition
    • Work with the patient/family/carers to develop a management plan that addresses the needs and preferences of the patient

  • Judgement and clinical decision making

    • Undertake continued timely reviews of patient progress and respond appropriately to any changes of condition
    • Able to explain decision making while performing a simple procedure
  • Leadership and management
    • Delegate appropriate tasks to junior members, ensuring supervision is maintained
    • Lead handover of patients within unit
  • Professionalism
    • Act as a role model of professional behaviour in the workplace
    • Identify and actively intervene in areas of unprofessional behaviour

  • Scholarship and teaching

    • Provide effective supervision using recognised techniques and skills (availability, orientation, learning opportunities, role modelling, delegation)
    • Adapt level of supervision to learner’s competence and confidence
    • Conduct assessments of (e.g. mini-CEX, 360° assessment), and observe, juniors; discuss and escalate performance issues where appropriate

  • Technical expertise

    • Able to demonstrate that basic essential surgical skills constructs are well established
    • Able to teach basic Essential Surgical Skills constructs to juniors and supervise their clinical application established