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RACGP backs IMG red tape reduction


Jolyon Attwooll


10/10/2022 5:08:11 PM

Federal Government bureaucracy can be cut but the college makes no apology for ensuring standards are maintained, says RACGP Rural Chair.

Doctor on phone
The application process for IMGs wishing to work in Australia often takes more than a year.

RACGP Rural Chair Dr Michael Clements knows only too well the obstacles facing practices wishing to recruit international medical graduates (IMGs).
 
The challenges, which have existed for many years, were highlighted in the media last weekend following comments by NSW Health Minister Brad Hazzard. He said delays ‘should be ringing alarm bells in the offices of the Federal Health Department and the Royal Australian College of General Practitioners’ and that they risked creating a healthcare ‘apocalypse’.
 
At Dr Clements’ Queensland practice it took a total of 18 months to take on a GP previously based in the UK – and he says it is commonplace for the bureaucracy to take more than a year.
 
‘I certainly agree with [Minister Hazzard’s] comments that it’s a very long and arduous process to go from being interested in working in Australia to actually delivering services,’ Dr Clements told newsGP.
 
While he welcomes the spotlight on the issue, the resolution of which he believes is crucial to addressing current workforce shortages, he believes the administration needs to be addressed at a Federal level, rather than by the college.
 
‘We don’t accept that there should be a different rule of standards for whether you see a doctor in the middle of Sydney versus Burke,’ Dr Clements said.
 
‘The Australian public expects to be able to walk into any GP clinic in any state in any city and rural town and have a level of reassurance about the skills and safety of that particular clinician, and also the supervision standards.
 
‘We don’t apologise for the standards that we maintain.’
 
In response to a newsGP inquiry, the Australian Health Practitioner Regulation Agency (AHPRA) said the process usually takes 6–8 weeks ‘once we have a complete application’ – although a query about the average time of applications was not addressed.
 
‘Our assessment processes must be robust,’ an AHPRA spokesperson told newsGP.
 
‘The level and type of information we ask for aims to ensure adequate protection for the public.
 
‘Sometimes, practitioners also need to complete assessments with others before applying for registration.’
 
They said documents need to be carefully assessed which can involve repeated correspondence  with the applicant to ensure registration standards are met.
 
‘Sometimes, practitioners also need to complete assessments with others before applying for registration,’ the spokesperson said.
 
AHPRA also pointed to recent moves announced to address the issue at National Cabinet level.
 
‘We are pleased First Ministers have decided to progress our proposals to improve skills and qualifications recognition,’ they stated.
 
‘We look forward to working closely with colleges, governments, accreditation authorities and other stakeholders to progress this work.’
 
At a National Cabinet meeting last month, First Ministers also agreed to an ‘independently-led, rapid review of regulatory settings for both Australian and overseas trained health professionals’.
 
The report is due early next year.
 
For Dr Clements, much of the problem derives from an overly rigid bureaucracy.
 
‘Each department wants to wait for the other department to do their job before they do their step,’ he said.
 
‘That’s where a lot of the delays are.
 
‘What we’ve been talking to [Federal Minister for Health and Aged Care Mark Butler’s] office about is parallel processing, where everything can happen at once, and then there’s a final sign off.’
 
He also believes there is not enough support for IMGs coming to Australia.
 
‘They’re on their own,’ he said. ‘They’ve got to navigate these exams, these systems, these processes, the costs are very expensive by themselves – and there’s nobody coordinating that.’
 
It is an area where Minister Hazzard could have some influence, according to Dr Clements.
 
‘He’s very welcome to start some programs within New South Wales to identify these doctors, mentor them, give them clinical placements in hospitals, support them with education, training, language support,’ he said.
 
‘For many of them, that big delay is in learning the Australian system, getting up to scratch with how GPs work here.
 
‘New South Wales Health is very welcome to contribute to this space and support them do that.’
 
More than half (52%) of the rural GP workforce already comprises IMGs, and with the issues caused by border closures now lifting, they are also likely to be crucial to address the current workforce shortfalls.

‘We’re in such a GP crisis right now, both urban and rural, that we need to see some quick results,’ Dr Clements said.
 
‘And that’s only going to come from international medical graduates, not from university students. because the pipeline is so long there.
 
‘We’re really grateful that Minister Hazzard has identified this group of people need support.
 
‘Some of it is within New South Wales Health’s control and we welcome discussions with him on how to do that.
 
‘We shouldn’t really be pointing fingers at whose fault it is. We just need to talk about what we’re going to do about it.’
 
The RACGP has published guidelines on how to migrate to Australia as an international GP on its website.                                 
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Dr Annette Hackett   11/10/2022 5:43:07 AM

Just questioning the thinking behind the push to get more IMG's to Australia. Why don't we encourage our own GP's (and yes, I acknowledge the barriers we all know when finding the answer to that question)? Why are we taking medical professionals from countries where they are needed more than here? I'm not denying that everyone has the right to make the best choice for their own family, and have worked with many IMG's who make a fantastic contribution to their adopted Australian community (just as likely as any Australian graduate). But I worry that we are taking from countries that really can't afford the loss that we in Australia, a very rich country, can far more easily overcome. The shortage of GP's is worldwide (I'm currently doing a locum in New Zealand, and it's worse here than in Australia), but Australia has more resources than many of the countries we are taking from. I'm just asking that people think before we take.


Dr Javier Armando Campuzano Ortiz   11/10/2022 2:08:00 PM

Well, dear Anette, I have been hearing that argument for the last 17 years every single time this comes up and is always a local graduate, is a very polite way to say, "no thank you we do not want you here, stay somewhere else maybe you'll be missed there". you don't need to worry about other countries, I certainly only worry about mine, Australia ( my passport says my nationality is Australian). I have always found that little argument offensive and that , "and have worked with many IMG's who make a fantastic contribution to their adopted Australian community (just as likely as any Australian graduate)" sounds very condescending. you don't need to clarify that "sometimes" we can be "as good as a local graduate" the truth is, we can be better sometimes. If we met the same standard which is what the article is about you don't need to clarify that. I have seen that little speech you just wrote many times in many different ways. you probably don't know that but sounds condescending.


Dr Farid Zaer   11/10/2022 6:34:56 PM

Every time you cut down the size of the "pie" the government will give you a smaller one. Being selfish and not caring about the welfare of the country gives you a smaller pie, so eat what you get, and next year they will make it even smaller. Do not justify standards by selfish behaviour. The earth can hold 1 trillion humans and we have 7.8 billion, but we don't want more people,selfish humans!


Dr Peter James Strickland   11/10/2022 6:59:50 PM

The first thing to do is get rid of APHRA itself, and bring back registration to the States --then anyone locally applying to go into GP work has already been monitored by the 'system' in most cases, and any overseas applicant can be reassured they will have their application assessed much faster, and any possible monitoring can be done locally. This system worked so well in the past, and once APHPRA came 'on the scene' everything became expensive for all medical practitioners, and bureaucracy ruled. Imagine teachers, tradesmen, police, lawyers etc being approved to do their work via a central bureaucracy --there is no better way than locally with respect to monitoring and assessing competency, AND ensuring ethics are preserved, and controlled by local State medical, nursing, dental etc Boards. Who assesses APHPRA anyway for their standards and decisions? It is time to revert back to local Boards, and the RACGP to tell Government that is what is required now to solve GP shortages.


Dr MD Shah Fakhruddin   11/10/2022 11:05:33 PM

Hi l have been listening same topic near about 20 years, GP shortage since l started my new life in Australia, as myself there are lot IMG GP working with local GP in rural areas
But RACGP not using already existing GP
Making harder for them
Making even experience issues that has also changed bad to worse, like l am already working as Gp more than 12 yrs and total Australian health service for more than 20
Yrs still l have reassess my experience?
So that means RACGP doesn’t want IMG
Doctors rather than improrted British/or other countries Doctors
So Still there is way to use already existing Gp in IMG who are in work force let them work in rural area with unconditional provider number until they pass their fellowship exam
Thanks again


Dr Amit Patel   12/10/2022 8:48:14 AM

The 12-18 months bureaucracy is before you arrive in Australia. The final part of the AHPRA process can only be done after you arrive and that can take a lot more than the “usual” 6-8 weeks during which time an IMG is not able to work.
A straightforward process like passport renewal now takes more than 3 months so it is not entirely surprising that the more complex process of checking and registering an IMG is going to be a very long time.
The NSW government should consider making it a more attractive career choice for Australian graduates instead.