GP Internship Placements Needs Intentional Design
You never have to tolerate abuse to belong in medicine: A/Prof Alam Yoosuff GP Finley
I have been a supervisor for GP intern placements since 2017. At the time, I was one of the very first GPs in New South Wales to take PGY1 interns into rural general practice.
My very first intern is now a GP obstetrician working in rural NSW — something I am immensely proud of.
The intern placement we built in Finley, NSW (MMM5) went on to become one of the most sought-after rotations in the Murrumbidgee region. That did not happen by accident. It happened because we were deliberate, thoughtful, and honest about what GP internship is — and what it is not.
GP internship is tricky — but it is absolutely doable
General practice internship is fundamentally different from hospital training.
GP interns:
Have a prescriber number but no provider number
Cannot bill
Cannot refer
Can write prescriptions
Require Level 1 supervision, meaning the supervising GP carries full clinical responsibility for every interaction
This means interns must be used judiciously.
Poorly designed placements can:
Disrupt workflow
Reduce GP billing efficiency
Increase cognitive and emotional load on supervisors
Frustrate interns rather than inspire them
Well-designed placements, however, can:
Provide rich, real-world clinical exposure
Improve practice workflow and viability
Make general practice attractive to junior doctors
Every practice is different. But I genuinely believe that if there is a will, there is a way to make GP internship work in almost any setting.
The hidden risks we don’t talk about enough
There is another aspect of GP internship that deserves far more attention: personal safety.
In general practice, interns often see patients alone in a closed room until the GP joins them.
This is very different from a ward environment, where:
Nurses and other staff are nearby and can respond quickly
Registrars are readily accessible
The environment is open, visible, and shared
In GP land:
The intern is the most junior clinician
The GP is the most senior — and often running behind, already seeing another patient
Calling for help can feel like “interrupting”
The intern may hesitate, not wanting to be a burden
This creates vulnerability.
Add to this another uncomfortable truth: patients know interns are temporary. They know they will ultimately see “the real GP.” Most patients are kind and supportive — but a small minority may:
Be dismissive
Be impatient
Speak disrespectfully
And, on very rare occasions, become aggressive
This week, I saw a junior doctor in tears after aggressive behaviour from a patient. That should never be dismissed as “part of the job.”
There is no justification for aggression or intimidation — even when a clinician is inexperienced, even when they are wrong.
The rule I have learnt tell interns: Open the door. Step out. Walk away.
You do not have to tolerate bad behaviour.
You do not have to endure intimidation to prove yourself.
You do not have to stay in an unsafe situation.
Stepping out is not weakness.
Handing over is not failure.
Asking for help is not incompetence.
It is good clinical judgement.
Interns will:
Make mistakes
Miss things
Not always know the answer
That is normal. That is training.
Our job as supervisors, practice owners, senior clinicians, and system leaders is not to throw them in the deep end and see who survives.
Our job is to:
Design placements intentionally
Protect safety and dignity
Stand beside our most junior colleagues — not behind them
If we want more junior doctors to choose general practice — especially rural general practice — then first exposure matters.
When GP internship is done well, it doesn’t just train doctors.
It shapes careers. It builds confidence.
And to every intern reading this: You never have to tolerate abuse to belong in medicine. You belong here. You are supported.
Dr Alam Yoosuff, GP/VMO, Finley NSW