Overseas trained doctors in Australia

Last updated

Overseas trained doctors in Australia (OTDs) are medical practitioners who completed their core medical training overseas. Historically, from time to time there has been a shortage of qualified medical practitioners in Australia, especially in rural Australia, [1] and the Australian Government has at times encouraged immigration for such graduates to Australia.

Contents

Australia has welcomed and continues to rely on a considerable number of doctors from overseas, with the largest numbers from the UK, India, Malaysia, China and New Zealand. The number of overseas born doctors in Australia has increased in recent years (though not all are overseas trained). In 2011, more than half of GPs (56%) and just under half of specialists (47%) were born overseas, up from 46% and 37% respectively in 2001. In comparison, less than a third (28%) of the total employed population of Australia in 2011 were born overseas. [2]

Licensing and registration

International medical graduates who wish to be licensed in Australia must apply to the Australian Medical Council (AMC) to arrange an appropriate assessment pathway. [3] The standard pathway involves an IMG sitting a series of assessments, including an AMC Multiple Choice Question (MCQ) Exam and an AMC clinical exam. [4] AMC MCQ Exam consists of 150 MCQs organized through computer adaptive scoring.

For AMC clinical exam, a candidate is required to pass 10 out of 16 cases which has 2 pilot cases.

Those OTDs who have passed the necessary exams and obtained AMC certification can then apply to an Australian specialty training positions. [5]

Australia is in the process of establishing a national registration process for all the doctors under Medical Board of Australia.

In 2010 the Minister for Health and Ageing (Australia) launched an Inquiry process into registration and accreditation processes for international medical graduates which reported in 2012. [6] Recommendations included measures around procedural fairness, transparency and efficiency in recognising OTDs especially for specialist training and qualification.

Immigration policy

Australia has a restricted Immigration Policy since the 1950s, where potential immigrants are assessed based on a number of characteristics, including education and profession. [7] Immigration was restricted often to whites through the White Australia Policy, and with the end of the White Australia Policy after about 1966 to 1973 [8] many of the modern first non-white immigrants (from India for example) were overseas trained doctors. [9]

While Medical Practitioners have often been encouraged to immigrate, there has been resistance in some quarters despite a continued rural shortage. [10]

The Australian Medical Association recognised the importance of OTDs, however highlighted the need to train doctors locally. [11]

In 2016 Skilled migration lists were updated to remove 41 medical fields of expertise, in an effort to restrict immigration of OTDs. [12] However, as of 2017, 33 medical fields of expertise remain on the list, [13] with 9 flagged for removal [14]

Controversy

While some argue it is harder to qualify as an overseas trained doctor than as a locally trained doctor in Australia, [15] despite the stringent processes, there is a perception that OTDs and non-white doctors in particular face discrimination. [16] [17]

While base medical practice licensing is one hurdle, speciality recognition has proven considerably more difficult for some OTDs. In one case, the Australasian College for Emergency Medicine was criticised for passing only 6.8% of non-white applicants whereas 88% of white caucasians passed. [18] In 2017 the college initiated an inquiry chaired by Dr Helen Szoke [19]

A study showed that OTDs attracted 24% more complaints and 41% more adverse findings than non-OTDs in Australia, with the study acknowledging that complaints leading to adverse findings were not always an objective measure of deficient practices. [20]

A number of high-profile cases involving OTDs include:

Related Research Articles

In the medical profession, a general practitioner (GP) or family physician is a physician who treats acute and chronic illnesses and provides preventive care and health education to patients of all ages. GPs' duties are not confined to specific fields of medicine, and they have particular skills in treating people with multiple health issues. They are trained to treat patients to levels of complexity that vary between countries. The term "primary care physician" is more usually used in the US. In Asian countries like India, this term has been replaced mainly by Medical Officers, Registered Medical Practitioner etc.

<span class="mw-page-title-main">Medical license</span> Occupational license that permits a person to legally practice medicine

A medical license is an occupational license that permits a person to legally practice medicine. In most countries, a person must have a medical license bestowed either by a specified government-approved professional association or a government agency before they can practice medicine. Licenses are not granted automatically to all people with medical degrees. A medical school graduate must receive a license to practice medicine to legally be called a physician. The process typically requires testing by a medical board. The medical license is the documentation of authority to practice medicine within a certain locality. An active license is also required to practice medicine as an assistant physician, a physician assistant or a clinical officer in jurisdictions with authorizing legislation.

Doctor of Medicine is a medical degree, the meaning of which varies between different jurisdictions. In the United States, and some other countries, the M.D. denotes a professional degree. This generally arose because many in 18th-century medical professions trained in Scotland, which used the M.D. degree nomenclature. In England, however, Bachelor of Medicine, Bachelor of Surgery was used and eventually in the 19th century became the standard in Scotland too. Thus, in the United Kingdom, Ireland and other countries, the M.D. is a research doctorate, honorary doctorate or applied clinical degree restricted to those who already hold a professional degree (Bachelor's/Master's/Doctoral) in medicine. In those countries, the equivalent professional degree to the North American, and some others' usage of M.D. is still typically titled Bachelor of Medicine, Bachelor of Surgery (M.B.B.S.).

A medical school is a tertiary educational institution, professional school, or forms a part of such an institution, that teaches medicine, and awards a professional degree for physicians. Such medical degrees include the Bachelor of Medicine, Bachelor of Surgery, Master of Medicine, Doctor of Medicine (MD), or Doctor of Osteopathic Medicine (DO). Many medical schools offer additional degrees, such as a Doctor of Philosophy (PhD), master's degree (MSc) or other post-secondary education.

<span class="mw-page-title-main">Kevin Andrews (politician)</span> Australian politician (born 1955)

Kevin James Andrews is an Australian former politician and member of the Liberal Party of Australia. He was the Member of House of Representatives for the seat of Menzies from a by-election in 1991 until the 2022 Australian federal election. Andrews is a conservative and a Catholic.

The Australian Medical Council (AMC) is an independent national standards and assessment body for medical education and training. It was established in 1985.

<span class="mw-page-title-main">Family medicine</span> Medical specialty

Family medicine is a medical specialty within primary care that provides continuing and comprehensive health care for the individual and family across all ages, genders, diseases, and parts of the body. The specialist, who is usually a primary care physician, is named a family physician. It is often referred to as general practice and a practitioner as a general practitioner. Historically, their role was once performed by any doctor with qualifications from a medical school and who works in the community. However, since the 1950s, family medicine / general practice has become a specialty in its own right, with specific training requirements tailored to each country. The names of the specialty emphasize its holistic nature and/or its roots in the family. It is based on knowledge of the patient in the context of the family and the community, focusing on disease prevention and health promotion. According to the World Organization of Family Doctors (WONCA), the aim of family medicine is "promoting personal, comprehensive and continuing care for the individual in the context of the family and the community". The issues of values underlying this practice are usually known as primary care ethics.

<span class="mw-page-title-main">Australasian College for Emergency Medicine</span>

The Australasian College for Emergency Medicine (ACEM), based in Melbourne Australia, is the primary training body for specialist emergency physicians in Australia and New Zealand. The college is recognised by the Australian Medical Council and Medical Council of New Zealand as such and provides services for approximately 2700 Fellows and 2600 Trainees.

The Primary FRCA is a postgraduate examination in anaesthesia, more fully called the Primary Examination of the Diploma of Fellowship of the British Royal College of Anaesthetists (RCoA).

<span class="mw-page-title-main">Medical education in Australia</span> Summary of education and training of medical practitioners (doctors) in Australia.

Medical education in Australia includes the educational activities involved in the initial and ongoing training of Medical Practitioners. In Australia, medical education begins in Medical School; upon graduation it is followed by a period of pre-vocational training including Internship and Residency; thereafter, enrolment into a specialist-vocational training program as a Registrar eventually leads to fellowship qualification and recognition as a fully qualified Specialist Medical Practitioner. Medical education in Australia is facilitated by Medical Schools and the Medical Specialty Colleges, and is regulated by the Australian Medical Council (AMC) and Australian Health Practitioner Regulation Agency (AHPRA) of which includes the Medical Board of Australia where medical practitioners are registered nationally.

<span class="mw-page-title-main">Royal College of General Practitioners</span> Professional body for doctors in the UK

The Royal College of General Practitioners (RCGP) is the professional body for general (medical) practitioners in the United Kingdom. The RCGP represents and supports GPs on key issues including licensing, education, training, research and clinical standards. It is the largest of the medical royal colleges, with over 50,000 members. The RCGP was founded in 1952 in London, England and is a registered charity. Its motto is Cum Scientia Caritas – "Compassion [empowered] with Knowledge."

<span class="mw-page-title-main">Royal Australian College of General Practitioners</span>

The Royal Australian College of General Practitioners (RACGP) is the professional body for general practitioners (GPs) in Australia. The RACGP is responsible for maintaining standards for quality clinical practice, education and training, and research in Australian general practice. The RACGP represents over 40,000 members across metropolitan, urban, rural and remote Australia.

<span class="mw-page-title-main">General Medical Council</span> Healthcare regulator for medical profession in the UK

The General Medical Council (GMC) is a public body that maintains the official register of medical practitioners within the United Kingdom. Its chief responsibility is to "protect, promote and maintain the health and safety of the public" by controlling entry to the register, and suspending or removing members when necessary. It also sets the standards for medical schools in the UK. Membership of the register confers substantial privileges under Part VI of the Medical Act 1983. It is a criminal offence to make a false claim of membership. The GMC is supported by fees paid by its members, and it became a registered charity in 2001.

<span class="mw-page-title-main">Occupational English Test</span>


The Occupational English Test is an English language test that assesses the English language proficiency of overseas-trained healthcare professionals seeking to register and practise in an English-speaking environment.

An international medical graduate (IMG), earlier known as a foreign medical graduate (FMG), is a physician who has graduated from a medical school outside of the country where he or she intends to practice. The term non-local medical graduate may be similarly used in countries with distinct licensing regions within them. Generally, the medical school of graduation is one listed in the World Directory of Medical Schools (WDOM) as accredited by the Foundation for Advancement of International Medical Education and Research or the World Health Organization.

Mohamed Haneef is an Indian born doctor who was falsely accused of aiding terrorists, and left Australia upon cancellation of his visa amid great political controversy. His visa was later reinstated and he was given some compensation.

Step 3 is the final exam in the USMLE series of examinations. It is part of the licensing requirements for Doctors of Medicine (M.D.), including international medical graduates aiming to practice medicine in the United States. Generally, it is a pre-requisite of the majority of the state licensing boards.

The British Association of Physicians of Indian Origin (BAPIO) is a voluntary organisation for doctors of Indian sub-continental origin, established in 1996 and based in the United Kingdom. Its president is Ramesh Mehta of Bedford Hospital NHS Trust.

<span class="mw-page-title-main">Australasian College of Sport and Exercise Physicians</span>

The Australasian College of Sport and Exercise Physicians (ACSEP) is a not-for-profit professional organisation responsible for training, educating, and representing over 350 doctors in Australia and New Zealand. These doctors practise medicine in the specialty of sport and exercise medicine (SEM). The ACSEP is the smallest of the 15 recognised specialist medical Colleges in Australia with approximately 260 Fellows and Registrars in 2020.

The National Eligibility Entrance Test (Postgraduate) (or NEET (PG)) is a qualifying and ranking examination in India, for students who wish to study various postgraduate Doctor of Medicine (MD), Master of Surgery (MS), Diplomate of National Board (DNB), Doctorate of National Board (direct 6 years course in the field of Neurosurgery, Cardiothoracic Vascular Surgery, Plastic Surgery and Pediatric Surgery) and diploma courses, in government or private medical colleges in the country. This exam replaced All India Post Graduate Medical Entrance Examination (AIPGMEE).

References

  1. "Fears doctor shortage could wipe out small communities". Australian Broadcasting Corporation . 7 January 2017. Retrieved 18 April 2017.
  2. "Main Features – Doctors and Nurses". Australian Bureau of Statistics. Retrieved 18 April 2017.
  3. "IMG guides: Applying to the Australian Medical Council". Australian Medical Council. 27 February 2012. Archived from the original on 8 July 2014. Retrieved 7 June 2014.
  4. "Assessments & examinations: Standard pathway". Australian Medical Council. 27 February 2012. Archived from the original on 27 June 2014. Retrieved 7 June 2014.
  5. "AMC – Preliminary information and application form for the AMC Examination". 13 June 2008. Archived from the original on 13 June 2008. Retrieved 18 April 2017.
  6. "Inquiry into Registration Processes and Support for Overseas Trained Doctors". Parliament of Australia. Retrieved 2 June 2014.
  7. "Skilled migration to Australia" . Retrieved 18 April 2017.
  8. "Fact sheet – Abolition of the 'White Australia' Policy". Archived from the original on 13 December 2017. Retrieved 18 April 2017.
  9. "Origins: History of immigration from India – Immigration Museum, Melbourne Australia". Archived from the original on 30 July 2008. Retrieved 18 April 2017.
  10. "Calls to stop giving overseas-trained doctors visas to address rural shortage". Australian Broadcasting Corporation . 9 August 2016. Retrieved 18 April 2017.
  11. https://ama.com.au/sites/default/files/documents/OTDPositionStatement2004.pdf [ bare URL PDF ]
  12. "Plan to stop foreign doctor flow". The Australian. Retrieved 18 April 2017.
  13. "Skilled Occupations List (SOL)". Department of Immigration and Border Protection, Australian Government. Archived from the original on 5 March 2017. Retrieved 1 April 2017.
  14. "Flagged Occupations on the SOL for 2016–17". Department of Education and Training, Australian Government. 18 April 2017. Retrieved 18 April 2017.
  15. Hyland, Tom (20 November 2011). "Foreign doctors' obstacle course 'a disgrace'" . Retrieved 18 April 2017 via The Sydney Morning Herald.
  16. "Migrant doctors 'face discrimination'" . Retrieved 18 April 2017.
  17. "Submission by the Australian Doctors Trained Overseas Association" . Retrieved 18 April 2017.
  18. "Doctors 'lacking in key skills'". The Australian. Retrieved 18 April 2017.
  19. "Emergency Medicine college ACEM appoints former human rights commissioner to investigate claims of systemic racism in training". 9 February 2017. Retrieved 18 April 2017.
  20. Elkin, Katie; Spittal, Matthew J.; Studdert, David M. (1 January 2012). "Risks of complaints and adverse disciplinary findings against international medical graduates in Victoria and Western Australia". Med. J. Aust. 197 (8): 448–452. doi:10.5694/mja12.10632. PMID   23072241. S2CID   8836294 . Retrieved 18 April 2017 via eMJA.
  21. "Doctor 'was in hurry to get home'" . Retrieved 18 April 2017.
  22. "Indian doctor 'won't be sacked today' – National – smh.com.au". 8 August 2007. Retrieved 18 April 2017.
  23. "Haneef's colleague sacked". 23 August 2007. Retrieved 18 April 2017.
  24. "Discrimination against international medical graduates: Wang v Australian Capital Territory » Russell Kennedy Lawyers" . Retrieved 18 April 2017.
  25. "'Fake doctor' Shyam Acharya reportedly tracked down in India by NSW Police". 14 March 2017. Retrieved 18 April 2017 via The Sydney Morning Herald.
  26. "7 News Sydney". Facebook . Retrieved 18 April 2017.
  27. "Suspended medico goes to ground". The Australian. Retrieved 18 April 2017.
  28. Aubusson, Kate; Trembath, Murray (14 April 2017). "Dr Kiran Phadke cleared to practise oncology after year-long chemo probe" . Retrieved 18 April 2017 via The Sydney Morning Herald.
  29. "Cancer doctor Kiran Phadke's 'life ripped away'". The Australian. Retrieved 19 April 2017.