Caring for kids: Australian general practice registrar confidence in delivering paediatric primary care

AUSTRALIA, the burden of disease for children experiencing non-acute conditions, such as behavioural, developmental and some mental health issues, has been increasing. 1,24]5 General practitioners (GPs), who are doctors qualified in general medical practice, are often the first point of contact for someone with a health concern.In the Australian primary care setting, GPs are at the forefront of child and adolescent healthcare 6,7 and play a crucial role in addressing the growing disease burden in this age group. 8,9Preparation of trainee doctors (referred to as GP registrars) for this key role begins during specialist training in general practice.The amount of exposure to non-acute paediatric presentations that GP registrars receive during training might impact their confidence when managing these conditions, where confidence refers to a belief in their abilities at carrying out a particular skill or knowledge set. 10 A UK survey of paediatric registrars reported that over half felt inadequately prepared for managing long-term, chronic conditions, as their training was primarily in acute care settings. 11GP registrars were expected to be even less confident than paediatric registrars as they receive less exposure to non-acute paediatrics during their GP training. 11he Registrars Clinical Encounters in Training (ReCEnT) 12 study documents the in-consultation clinical and educational experiences and actions of GP registrars across Australia.Data from this study indicate that paediatric encounters during GP training are mostly for acute presentations.Further, GP registrars typically seek more advice from their supervisors and make referrals more often for paediatric patients than for adult patients. 6,13ne explanation for these findings is that GP registrars experience a relative lack of confidence in treating non-acute paediatric presentations.Our recent study of Victorian GP registrars found that prevocational paediatrics training was mainly obtained in acute care settings and that registrars