Advancing Your Career: The Importance of Procedural Skills in General Practice

Introduction

General practice in Australia has evolved far beyond consultations and prescriptions. Modern GPs routinely perform procedures that directly improve patient outcomes and generate substantial practice income. Procedurally trained GPs report higher job satisfaction, increased practice revenue, and expanded professional autonomy.

Over 1 in 10 general practice consultations include a procedural component—from skin biopsies to intrauterine device (IUD) insertions. For ambitious doctors, developing procedural expertise represents both a clinical advancement and a financial opportunity. This article outlines common GP procedures, training pathways, and strategies for building a procedurally focused practice.

Common GP Procedures: Frequency and Scope

Research into GP registrars reveals which procedures are most commonly performed in Australian general practice.

Procedure	Frequency (% of registrars)	Notes
Skin biopsy/excision	20.40%	Most common procedural GP activity
Incision & drainage (abscess)	15.20%
Subcutaneous injections	13.00%
Medication administration	11.80%
Implanon insertion	11.00%
Suturing/wound repair	11.00%	Essential trauma skill
Cervical screening	High frequency	Preventive procedure
IUD insertion/removal	Common	Contraceptive procedure
Joint injections	Variable	Urban < Rural

Rural vs. Urban Difference: Rural GPs perform procedures at higher frequency, reflecting patient demand and limited specialist access.

Procedural Categories and Scope

Avant, the largest GP insurer, defines three main procedural GP categories with distinct scope limitations:

Standard Procedural General Practice

This is the most common category for GPs developing procedural skills:

Included Procedures:

• Skin cancer excision (minor; elliptical excisions with primary wound closure)

• Vasectomy (no-scalpel technique)

• Minor regional anaesthesia (axillary nerve blocks, minor injections)

• Joint injections (shoulder, knee, ankle, etc.)

• Circumcision (male)

• Dilatation & curettage (D&C)

• IUD insertion/removal

• Removal of skin lesions, sebaceous cysts, lipomas

  
  

Income Potential: $2,000–$8,500 per 6-month period in procedural payments (tiers 1–4); plus Medicare rebates for procedures.

Non-Standard Procedural General Practice

Extended scope for highly trained GPs with additional qualifications:

Included Procedures:

• Termination of pregnancy (up to 22 weeks gestation)

• Appendectomy

• Hernia repair

• Minor orthopaedic procedures (carpal tunnel surgery, knee arthroscopy)

• Surgical assistance

  
  

Requirements: Additional formal training and credentialing; often limited to procedural subspecialists.

Procedural Obstetrics (DRANZCOG Pathway)

For GPs managing pregnancy, labor, and delivery:

Included Procedures:

• Intrapartum obstetrics (labor management)

• Caesarean section

• Repair of complex perineal trauma

• Management of obstetric emergencies

  
  

Income Potential: $15,000–$20,000+ per delivery (private billing); plus rural obstetric incentives.

Extended Skills Training: The Gateway to Procedural Expertise

All GP registrars on AGPT or FSP programs must complete one mandatory 6-month Extended Skills Training (EST) term. This is your ideal opportunity to develop procedural expertise.

EST Options for Procedural Development

• Skin Cancer Medicine: Dermoscopy, excision techniques, management

• Emergency Medicine: Procedures in acute care (wound repair, splinting, etc.)

• Obstetrics: Intrapartum procedures, delivery management, emergency obstetrics

• Sports Medicine: Joint injections, MSK ultrasound-guided procedures

• Sexual Health: IUD insertion, management of reproductive health conditions

  
  

How to Maximize Your EST for Procedural Skills

1. Plan early: Identify procedural interests in PGY1–PGY2.

2. Secure placement: Contact accredited training sites offering procedural EST.

3. Hands-on focus: Choose placements with high procedure volumes.

4. Mentorship: Work with experienced proceduralists for 1-on-1 training.

5. Competency assessment: Ensure supervisor verification of procedural competency before graduation.

   
   

Procedural Training Opportunities Beyond Training Program

Skin Cancer Medicine

• Training: 2–5 day courses in dermoscopy and excision.

• Cost: $500–$2,000 for courses.

• Competency level: Can be achieved within 3–6 months of dedicated training.

• Income: High—skin cancer practices command premium Medicare rebates and private fees ($150–$400 per procedure).

• Market demand: High, especially in regional Australia.

  
  

Vasectomy Training

• Training: No-scalpel vasectomy workshops (2–3 day hands-on courses).

• Cost: $1,500–$3,000.

• Procedure fee: $500–$1,200 per procedure.

• Demand: Steady in general practice; good income for a relatively simple procedure.

• Complications: Minimal if trained properly.

  
  

Joint Injection Courses

• Training: 2–4 day MSK-guided injection courses (ultrasound or landmark-based).

• Cost: $1,500–$3,500.

• Procedures: Shoulder, knee, ankle, hip, elbow, wrist.

• Income: $100–$300 per injection; high volume potential.

• Equipment: Requires ultrasound machine ($10K–$30K investment).

  
  

Advanced Obstetrics (DRANZCOG)

• Training: Formal postgraduate diploma (variable duration).

• Scope: Intrapartum care, delivery management, emergency obstetrics.

• Income potential: Highest among GP procedural skills ($15–$20K per delivery).

• Location: Primarily rural/remote; limited demand in metro areas.

• Requirements: Ongoing hospital rotation maintenance.

  
  

Anaesthesia Accreditation

• Training: Postgraduate diploma + supervised practice.

• Scope: General and regional anaesthesia for minor procedures.

• Income: $20,000–$30,000+ annually (procedural payments + private billing).

• Rural demand: High; often mandatory in remote hospitals.

  
  

Financial Incentives for Procedural GPs

Rural Procedural Grants Program (RPGP)

• Up to $20,000 annually for training and professional development.

• Covers procedural conferences, workshops, and supervised training days.

• Reimbursement-based ($2,000 per training day, up to 10 days).

• Eligibility: Rural/remote practitioners with procedural credentials.

  
  

Practice Incentive Program (PIP) Procedural Payments

• Tier 1: $2,000 per 6-month period.

• Tier 2: $2,000–$5,000 per 6-month period.

• Tier 3: $5,000 per 6-month period.

• Tier 4: $8,500 per 6-month period (highest complexity/volume).

• Eligibility: Rural/remote practices with credentialed procedural GPs.

• Annual potential: $17,000–$34,000 from PIP alone.

  
  

Medicare Rebates for Common Procedures

• Skin cancer excision: $80–$250 (varies by complexity).

• Vasectomy: $250–$400.

• Joint injections: $50–$150 per injection.

• IUD insertion: $100–$200.

• Obstetric delivery: $800–$2,500+ (private arrangements vary).

  
  

Competency and Safety Requirements

RACGP Standards require that all procedurally trained GPs:

1. Demonstrate competency before independently performing procedures.

2. Maintain currency through ongoing CPD (minimum annual).

3. Document assessments showing supervisor sign-off on specific skills.

4. Hold appropriate indemnity insurance with procedural extensions.

5. Participate in audit and feedback on procedural outcomes.

   
   

Notably, GPs report greater confidence in procedural management than diagnosis—suggesting that once you've been trained in execution, the skill becomes highly reliable.

Building a Procedurally Focused Practice

Strategic Approach

1. Choose your specialty: Identify procedural interests (skin cancer, obstetrics, etc.).

2. Plan during training: Maximize EST term for dedicated procedural learning.

3. Secure early employment: Post-fellowship, work in practice with procedural volume.

4. Invest in equipment: Ultrasound, dermatoscopy equipment (initial $5–$20K).

5. Market your skills: Promote procedural availability to patients and referrers.

6. Maintain currency: Annual CPD and audit to remain credentialed.

7. Develop referral networks: Partner with specialists to capture procedural referrals.

   
   

Conclusion

Procedural skills represent a significant differentiator for ambitious GPs. From skin cancer medicine generating $20,000+ annually to obstetric deliveries worth $15,000+ per case, procedural expertise directly impacts both income and professional satisfaction.

Your EST term during GP training is the ideal opportunity to develop foundational procedural competency. Combine this with post-fellowship professional development (workshops, courses, supervised practice) to build expertise in your chosen procedural niche.

In rural and remote Australia, procedural skills are not optional—they're essential to serving community needs and accessing financial incentives. In metropolitan practice, they provide professional differentiation and practice revenue enhancement.

Next Steps: Reflect on procedural interests. Plan your EST placement to focus on skill development. Post-fellowship, invest in ongoing training and equipment to establish your procedural scope.