Victoria's Single Employer Model trial for Rural Generalist Trainees

Thank you for your interest in the Single Employer Model trial

We are pleased to invite applications from eligible Rural Generalist trainees seeking to participate in the trial. Please complete this form to support the assessment of your application. For more information on the Single Employer Model, see Single Employer Model | health.vic.gov.au.

Collection notice

The Department of Health collects the information that you provide in this form for the purpose of administering the Single Employer Model application and management process. The information that you provide will be used to determine your eligibility, contact you regarding your application and participation in the program, and support program administration activities. If you do not provide all of the information requested, we may not be able to assess or process your application.

You can request access to, and correction of, any personal information provided in this form. For information on our handling of personal information and how to request access or correction, see our Privacy page.

We use the services of Snapforms to administer this form. Information collected through this form is hosted in Australia and managed in accordance with Snapforms' data hosting and security arrangements.

Please enter your contact details.

Name

Email Address

Phone Number

By signing up, you agree to be contacted by the Victorian Rural Generalist Program regarding the SEM.

Have you registered with the Victorian Rural Generalist Program

YesNo, but I intend to registerNo

Will you be entering general practice training in 2027 or 2028? *

YesNo

Please indicate your current level of training

Please indicate your Rural Generalist skill of interest (if known)

Have you enrolled in a rural generalist training pathway with RACGP or ACRRM

Yes - ACRRMYes - RACGPNo, but I Intend to enrolNo

Please provide the month that you intend to enrol

Please provide the year that you intend to enrol

Please enter the Region you are currently training in

Name of your current employing health service or primary care provider (if applicable)

Which SEM trial would you like to apply to? *

Gippsland (employed by Bairnsdale Regional Health Service)Grampians (employed by Grampians Health)Loddon Mallee (employed by Mildura Base Public Hospital)South West (employed by South West Healthcare)Hume (employed by Northeast Health Wangaratta)

Which rural Victorian town(s) are you interested in living and working in once Fellowed, and why?

If you have already been placed with a primary care provider for 2027, please provide the name of the primary care provider you have been placed with

Thank you for you interest, but the trial is for Rural Generalist trainees who are entering GP training in 2027 or 2028

Thank you for you interest, but the trial is for trainees who have enrolled or intend to enrol in RACGP or ACRRM for 2027 or 2028.

Thank you for your interest, but this opportunity is limited to Rural Generalist trainees registered with the VRGP.

Please register your interest here: https://www.vicruralgeneralist.com.au/contact

Thank you!

The Victorian Rural Generalist Program