RACGP welcomes fast-tracked IMG visas to tackle rural workforce issues

Doug Hendrie

16/10/2020 3:59:10 PM

Overseas-trained GPs will be able to expedite their visa applications as part of Australia’s COVID recovery efforts.

Australian visa
IMGs may help alleviate new rural health workforce issues.

The move has been welcomed by RACGP Rural Chair Dr Michael Clements as a way to address persistent and intensifying workforce challenges, at a time when border closures have restricted the fluid locum workforce on which many towns rely.
‘The RACGP is supportive of speeding up visas for international medical graduates [IMGs] as an important part of the solution,’ he told newsGP.
Australia will be reliant on IMGs for rural areas for the foreseeable future, according to Dr Clements.
‘Long term, we will grow our own GPs through rural generalism and similar programs. But it will not solve all our problems and certainly not in the near future,’ he said.
‘IMGs will continue to play a crucial role in our rural workforce.’ 
The Department of Home Affairs now lists GPs as one of 17 priority occupations, which also include nurses, medical practitioners and psychiatrists.
Priority listing means visa applications – which can take months – will be accelerated, as will the ability to travel across closed state borders.
The move represents a partial reversal of the Federal Government’s 2018 decision to slash IMG visa numbers by 800 over four years, seen as a recognition that locally-trained GP numbers were growing.
Dr Clements is currently recruiting for his own practice on Magnetic Island off Townsville, which has long been challenged by workforce issues. He has recently recruited local GPs and one from overseas.
‘This is an area of need with a GP shortage. I offered a contract to a doctor in Scotland [because] she really stood out, showing her commitment to rural communities,’ Dr Clements said. ‘As a practice owner, it’s important I have the breadth of skills [among GPs] to meet community needs. Recruiting internationally helps me do that.
‘But the whole process takes six to nine months. So, as a rural practice owner, I welcome this change.
‘We recognise IMGs form a crucial part of the rural workforce. There are many examples of very successful international recruitment. The IMG visa has formed a core part of the Government plan for rural workforce shortages.
‘The COVID limitations on interstate travel have decimated the fluid locum workforce that normally moves around. This change is welcome.’
Under the 10-year moratorium rules, IMGs are required to work in areas of workforce shortage – which are usually rural or remote – for up to 10 years if they want to be able to bill Medicare.
But Dr Clements does not believe visa restrictions and the moratorium are a ‘complete solution’ for the rural workforce, given the tendency for overseas-trained GPs to move to the major cities once their moratorium period was over.
‘It’s implied is that IMGs often go to cities, but I don’t think that’s fair – there are many rural and remote GPs who did not get their degree in Australia, who are providing wonderful service. And there are many who stay [in rural areas],’ he said.
‘We urge the Government to focus more on recruitment initiatives to draw people into rural and regional areas, rather than arbitrary mandated rulings.
‘While we can have hypothetical discussions on why we prefer locally trained doctors for local areas and the fact the moratorium and restrictions on IMGs don’t work, the reality is IMGs still form an important lifeline for many rural communities and they should remain one of the many options.’
Dr Clements questioned the 2018 reduction in IMG visas, which was pitched as a measure saving an estimated $415 million.
‘When the Government says they’re saving Medicare by having fewer IMG visas, what they’re really saying is they’re reducing the number of patient consultations. That’s not a good thing,’ he said.
The Government states the priority migration list is temporary, meaning the occupations listed may change.
Around 30% of Australia’s medical workforce originally trained overseas, with the percentage higher in more rural communities.
A 2019 paper found that, despite numbers of Australian-trained doctors more than doubling since the late 1990s, recent locally trained graduates are ‘less likely to work either as general practitioners (GPs) or in rural communities compared to local graduates of the 1970s–1980s’.

It also found the proportion of overseas trained doctors was increasing among rural GPs and other medical specialists for each cohort of doctors entering the medical workforce since the 1970s, and peaked for entrants in 2005–09.
‘Australia relies heavily on [IMGs] for rural medical workforce capacity, both as GPs and other medical specialists, for access to medical services in large and small communities and this reliance is increasing,’ the paper states.
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Dr Alireza Yadollahi Farsani   20/10/2020 8:06:36 AM

It is nearly impossible to get a job in rural areas due to DPA limitations and also AHPRA requirements to have 2 supervisors at the time of applying for registration plus difficulties to pass pesci , so Visa is not a big hurdle.

Dr Mahdi Vakili   20/10/2020 8:28:49 AM

I'm an IMG living in Australia and want to work in a rural area in Victoria or Tasmania or NSW for ever, I have emailed to more than 500 employers and phoned mor than 100 employers for that, but until now I couldn't find any job position in rural areas.
Do you know why?
Just for one reason:

they can't provide one supervisor and one co-supervisor for me in rural areas.

Dr Horst Paul Herb   20/10/2020 4:08:09 PM

While some IMGs might move into the city after their 10 years moratorium... the majority of colleagues I work with in remote and very remote areas (mostly MMM7) are IMGs who have been practising in Australia for 2+decades, have their fellowships, and have no restrictions on provider numbers. Myself being one of them. Like many others, I was attracted by the interesting work and lifestyle that remote areas offer.

That said, those areas are not suitable for inexperienced doctors. A safer way to fill those vacancies would be recruiting them into 2-3 year training programs in well resourced regional centres, providing an introduction into the emergency/obstetric/anaesthetic/surgical skills that are needed, and then perhaps giving them a rural or remotely bonded registration to ensure they hold up their part of the deal.

Dr Mohammad Abolfazl Ayati   20/10/2020 8:17:30 PM

How RACGP can play an important role in providing the rural areas of Australia with Qualified International Medical Doctors?
According to a short-term, 2 years Plan, RACGP can Simply prepare the Rural areas of Australia, with more than 500 well-qualified IMGs, using the following Method:
1- Ease the DPA and MMM conditions for the job offers
2- Reopen the PESCI examination ASAP or start the Online examinations for all States.
3- Fast Track the Registration Process by playing a coordination role between IMGs and APHRA
4- You've already done the Visa process Fast Tracking, Thank you.
5- Facilitate the IMGs who have 3 years assessed work certificate with the fast FRACGP exams, after one year of supervised work.
6- After achieving the Fellowship by the IMGs, The APHRA and RACGP would be able to use these well-trained, fresh FRACGP IMGs in Rural Areas, In a competing context or with an incentive-based approach to encourage the IMGs to consider the Remoteness Factors like DPA and MMM.