Inquiry process into registration and accreditation processes for international medical graduates


Inquiry into Registration Processes and Support for Overseas Trained Doctors was an evidence gathering exercise that took place in Australia, looking at a global medical workforce issue.

Call for an inquiry

The inquiry process into the accreditation process for International Medical Graduates and other matters was initiated after a question was put forward in front of the Australian parliament in September 2010 by Hon Warren Entsch, one of the elected representatives from the rural Australia.
The question that was raised was regarding the sudden deregistration of a highly qualified cardiologist practicing as a successful cardiologist in the regional area in the constituency of the concerned member of parliament. Serious concerns were expressed about the processes involved in the registration process of the overseas graduates and specialists working in Australia.
An inquiry was called for by the Minister for Health and Ageing in Australia and submissions were invited from all stakeholders, including international medical graduates.

Public hearings

Many overseas doctors have made submissions to the inquiry committee which are followed by public hearings.
During 2011 there were public hearings held in Canberra, Brisbane, Melbourne, Sydney, Perth, Cairns, Townsville, Adelaide, Newcastle, Gosford, Launceston, Tasmania and Darwin.
Medical Board Chair Dr Joanna Flynn made a statement that Medical Board of Australia follows a risk-based approach in assessing overseas doctors in order to match the Board's primary responsibility to protect public. On the other hand, she also said that the overseas doctors are an asset to the Australian Medical force.
The current mind-set and the risk-based approach towards the assessment may be the root cause of the problem and the ongoing inquiry into the registration process of overseas doctors highlighted the urgent need for the Medical Board of Australia to consider a serious change in its approach towards registration process of the overseas doctors from risk-based assessment to a facilitative role.
In another recent public hearing in front of the inquiry committee Dr Joanne Mary Flynn, Chair of the Medical Board of Australia made her second appearance in August 2011.
The committee members requested the Medical Board chairman to provide them with a rough estimate of the number of overseas doctors in Australia who are currently finishing their mandatory four-year deadline and were unable to the achieve the general registration as mandated by the Medical board. Dr Flynn replied that the four-year period starts for all the overseas doctors on 1 July 2010, no matter how long they have been in Australia before that. She also mentioned that while the medical board requires these doctors to demonstrate progress, they can renew that registration under the national law three times

Submissions

Several colleges and the public health employing authorities from all the individual states in Australia have also made submissions to this inquiry process.
Some of the submissions so far have highlighted the difficulties faced by the international medical graduates currently employed in Australia. The introduction of national registration process under the Medical Board of Australia and regulated by the AHPRA resulted in introducing many more obstacles to the progress of overseas doctors in Australia in the name of regulation.
The introduction of Medical Board of Australia and its handling of the registration process for overseas doctors is causing unnecessary distress and panic among the international medical graduates who are already established in Australia and serving in highly responsible positions in the community serving people.
Serious concerns were raised about the massive impact on rural health in Australia due to the unforeseen barriers imposed upon overseas doctors serving rural communities in the bush.
The inquiry committee did make a comment in the public hearings held so far that the current registration processes need closer evaluation and there may also be a need for regulation of the current registration process.
The inquiry committee also have repeatedly expressed doubts about the validity of the Accreditation process for International Medical Graduates applied to the foreign doctors by many of the colleges.
Many of submissions have also highlighted the inconsistencies and the unpredictable discrepancies in the accreditation process of international medical graduates with overseas specialist qualifications.
The affected doctors included many international medical graduates from countries like India, South Africa, and Canada.
Some of the specialists colleges made their individual submissions which included Royal Australian and New Zealand College of psychiatrists as well as Royal Australian and New Zealand college of obstetricians and gynaecologists.
The transcripts of all the inquiry committee public hearings are available for public access on the parliamentary web site. Some of these hearings have highlighted the extent of damage inflicted upon the professional careers of many of these international medical graduates in Australia due to the severe and unpredictable restrictions enforced upon these doctors in the name of registration requirements.
A cabinet reshuffle took place in December 2011 with The Hon Tanya Plibersek becoming the new health minister of Australia and Hon Nicola Roxon moving to take up the post of attorney-general.

Outcome

In March 2012 the final report was published. The AHPRA responded by welcoming the increased focus on International Medical Graduates and the suggestions for initiatives that could improve their experience of joining Australia’s healthcare system. Proposals from the report were expected to streamline and speed up the process used to approve doctors wanting to work in Australia who had trained elsewhere. Pilot studies that were undertaken after the report suggested that the process could be run at a relatively low cost. The report led to some recognition that Australia needed to make changes to how its health workforce is organised.