Fast-tracked registrations bypassing the bush: RACGP

A controversial initiative designed to fast-track the applications of international medical graduates wishing to work in Australia has been hailed a success by the medical watchdog, but the RACGP’s Rural Chair says the data tells a different story.
 
A new report released by the Australian Health Practitioner Regulation Agency (AHPRA) shows that up to 31 July, 229 specialist international medical graduates (SIMGs) have been approved and registered to practice in Australia through the new expedited specialist pathway.
 
This includes 208 GPs, 12 psychiatrists and nine anaesthetists, most of whom were qualified in the United Kingdom.
 
So far, approved SIMGs have been registered to practise in all states and territories, except Tasmania, with 47 in Victoria, 42 in New South Wales, 39 in Western Australia and Queensland respectively, 15 in South Australia, five in the Australian Capital Territory and one in the Northern Territory.
 
Around 86% of those will be working in areas identified as having a workforce shortage, while 20% will be specifically directed to regional, rural or remote areas where it is traditionally harder to recruit.
 
Medical Board of Australia Chair Dr Susan O’Dwyer, who praised the new pathway for striking a balance between safety and supply, said most of the newly registered doctors are heading for ‘fast-growing communities with limited access to medical care’.
 
But looking closely at the data, Associate Professor Michael Clements begs to differ.
 
‘In terms of the expedited pathway, it’s certainly a catchy phrase and it makes the Government sound like it’s taking action,’ the RACGP Rural Chair told newsGP.
 
‘What has concerned me though is that the absolute majority are moving to the cities, which is not where they are most needed.
 
‘We know the particular pathway that they’re on does allow them to work in MM1 locations that are identified as Distribution Priority Areas (DPAs), but the college has long held concern that DPA has been used as a political tool to guide doctors into certain suburbs.
 
‘We saw the Sunshine Coast, the Gold Coast and The Gap in the middle of Brisbane identified as DPAs by the Government just before the last election.’
 
According to previous AHPRA data, up to 30 April, 80% of applicants through the expedited pathway were approved to work in metropolitan areas (MM1), 9% in regional centres (MM2), 7% in rural areas (MM3–MM5), and 4% in remote areas (MM6–MM7).
 
Associate Professor Clements says this is in line with what he is hearing anecdotally.
 
‘It’s good that at least some of them are going to where we need them, but it wouldn’t be fair to phrase this as a tool that’s being used to solve community need,’ he said.
 
‘There’s been very aggressive recruitment pushed by some companies and corporates to drive doctors into city positions. The GP chat rooms now talk about some of these doctors being recruited into positions where they’re not busy, where they’re just not filling up their books because they’re in an area that already has lots of doctors and lots of appointments.
 
‘It breaks my heart as the Rural Chair when I see posts from some of these UK doctors saying, “I was promised I was going to be full from day one and it’s been six months and I’m still only seeing a handful of patients today”, when I know just a short way out of town, we’re still desperate.’
 
With Australia in the throes of a medical professional shortage for several years now, particularly where GPs are concerned, the expedited pathway was introduced as a way to streamline and fast-track applications from medical specialists qualified through similar health systems.
 
It enables them to apply directly to the Medical Board of Australia or AHPRA rather than be assessed individually by a specialist college like the RACGP, which the college fears has removed an important layer of safety and support.
 
According to the latest data, 80% of applicants are registered through the pathway in less than six weeks, with 41% registered in less than four weeks, 12% in 6–8 weeks, and 9% in more than eight weeks.
 
‘In 2024, 62% of SIMGs on the existing specialist pathway received their interim assessment outcome within four months and 14 days, with 9% taking more than nine months,’ AHPRA’s report noted.
 
Associate Professor Clements says the college welcomes the reduced wait time on approvals but notes it is ‘only one component of bringing a doctor out to Australia’.
 
‘That doesn’t include the applications for Medicare provider numbers, the visa status and all the other palaver that goes with getting a doctor actually working,’ he said.
 
‘We don’t want to overstate the impact that this is having on our community.’
 
The expedited pathway first opened to GPs in October 2024, followed by psychiatrists and anaesthetists in December 2024, and obstetricians and gynaecologists in March 2025.
 
Up to 31 July, 441 internationally qualified specialists have applied for registration in Australia, of which 370 were for general practice, 34 for psychiatry, 26 for anaesthetics and 11 for obstetrics and gynaecology. 
 
Of these, 183 applications are in various stages of assessment and yet to be finalised, while 26 applications have been withdrawn by the applicant and just one has been refused by the Board.
 
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AHPRA expedited specialist pathway GP workforce Medical Board of Australia SIMGs Specialist International Medical Graduates