Challenges facing newly arrived doctors in spotlight

Record numbers of doctors are moving to Australia but they still face many of the same challenges, a new Australian Medical Council (AMC) survey suggests.
 
Slow and complex processes, limited training opportunities, discrimination, and the significant impact on families are among the main themes raised by 4000 responses to an AMC survey emailed to around 60,000 international medical graduates (IMGs)
 
For Associate Professor Ayman Shenouda, who chairs the RACGP’s National IMG Committee formed earlier this year the findings are familiar.
 
‘It’s not a surprise at all,’ he told newsGP.
 
‘They are the same challenges that we’ve been talking about for years – the good thing is that the Medical Council has got an appetite to put things in place to address some of the issues.
 
‘This is about doctors serving rural communities for years and years, about supporting them, about understanding their issues and addressing them, because it’s crucial for the future of primary care in our country.’
 
The survey also found that more than half of the respondents reported experiencing discrimination, including what they saw as preferences for Australian-trained doctors in workplaces, and sexism, especially among female IMGs.
 
It revealed many IMGs felt that having to work in isolated locations made it difficult for families, and that the factors contributing to isolation and separation were job location or long processing times.
 
The AMC says the survey is part of a plan to improve the experience and support for international medical graduates. It cites reforms to its clinical exam, an increase in support for exam preparation and integration into the healthcare system, and more IMG representation in decision-making as among its initiatives.
 
Associate Professor Shenouda said he welcomed those changes.
 
‘The first thing is about supporting those doctors,’ he said.
 
‘The AMC report mentioned exam prep – to start preparing people for the exam and nature of the exam but also changing the format of the exam to suit IMGs is a good step forward.’
 
Reforms were prompted by the ‘Independent review of Australia’s regulatory settings relating to overseas health practitioners’ – widely known as the Kruk Review – which was commissioned by the Federal Government to facilitate more overseas doctors moving to the country.
 
Since the review was published, Australia has received a record number of IMGs with 4699 doctors registering to practice in Australia in the first 10 months of the last financial year, compared to the last annual pre-pandemic total of 2991 in 2018–19.
 
The review also led to an expedited pathway program opening from 21 October for GPs trained in Ireland, the UK and New Zealand, allowing those eligible to fast-track their registration.
 
According to the AMC, 56% of doctors working in general practice carried out their medical training overseas, compared to 31% of doctors overall.
 
The recent AMC survey does not detail the IMGs’ medical specialties, so there is no specific information on the numbers of respondents working in general practice, or their experiences.
 
It does note, however, significant variation in the amount of time taken by specialist IMGs to complete their transfer, with 70% of participants reporting ‘significant delays’.
 
‘RACGP had 12% of candidates who took longer than two years to complete the pathway, but for RANZCP and RACS the percentages were 44% and 55% respectively,’ the report states.
 
‘There are several factors causing difficulties and delays, and many candidates encounter more than one factor.’
 
As well as the AMC initiatives, Associate Professor Shenouda said the Government has a critical role to play.
 
‘As we support our local graduates in their training and spend time, effort and funding, it’s so sad to see that the Government has stopped funding for the FSP (Fellowship Support Program), which is the main program that supports IMGs to work towards fellowship,’ he said.
 
‘We need to fund, we need to integrate between the two programs one way or another.’
 
The AMC said many challenges highlighted in the survey reflect findings in Government reviews including the Kruk Review and the ‘Working Better for Medicare Review’, which was released last month with 26 recommendations to improve healthcare worker distribution.
 
Associate Professor Shenouda said a significant amount of work remains, but that the formation of RACGP’s IMG committee presents a ‘brilliant opportunity’ for collaboration.
 
‘We are at the starting point, but it is very positive, and I hope everyone will get together to make a difference,’ he said.
 
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