International medical graduates would be paid to take on grunt work as an alternate path toward full registration.
The Victorian government has supported a recommendation to introduce an “Assistants in Medicine” role in public hospitals, wherein final-year medical students and overseas trained doctors would complete clinical administrative tasks.
The recommendation came from a state government review of medical workforce systems and employment arrangements for public hospital staff completed in May 2024 but not released until this week.
The review looked at the challenges of recruitment and retention in rural areas, the unsustainability of relying on international medical graduates to fill workforce gaps and how GPs and rural generalists could be better integrated into the state hospital system.
One of the key findings was that the Medical Practitioners Award 2020 and other industrial instruments did not sufficiently cater for the needs of the health workforce or the communities they serve and that there are opportunities to expand the workforce while improving retention.
It’s the recommendations that came from this finding that may raise some eyebrows.
Specifically, that there should be a new employee classification – Assistants in Medicine – made up of individuals within 12 months of obtaining AHPRA provisional registration.
Two groups would be eligible to fill the new roles; final-year medical students and international medical graduates who have completed the first part of their Australian Medical Council qualification but are yet to obtain the Part Two accreditation allowing them to work under supervision.
The Victorian government sees this as killing two birds with one stone, in that it would increase the supply of registered medical officers while also “alleviating somewhat the burden of administrative tasks on hospital medical officers”.
Exactly how an assistant in medicine would spend their time is unclear, but the report refers to the role as consisting of administrative tasks in several places.
“Appropriate administrative support for clinical staff and doctors in management roles needs to be provided and sufficiently resourced,” the report read.
“It is envisaged that the new role of Assistants in Medicine would assist also with clinical administrative tasks.
“Such tasks might include managing communications/emails correspondence, scheduling, etc.”
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In its submission to the report, AMA Victoria called out the state government for a “lack of long-term workforce strategic planning” and noted that internationally trained doctors often receive inadequate support.
The association’s suggested fixes involved state-run health services offering financial support for visa requirements and relocation, as well as establishing an accredited “foundation year” pathway for migrant doctors who have satisfied all registration requirements.
“Establishing an accredited … pathway for doctors who have trained overseas … would benefit [internationally trained doctors] and the Victorian public health sector by ensuring that the [doctor] is provided with a supported opportunity to be enculturated into the Victorian public health sector, and into regional or rural community life,” the AMAV said.
The review put forward 20 recommendations, 19 of which were accepted either fully or in principle by the Victorian government.
The lone unsupported recommendation was that the Victorian health minister establish a doctor’s advocate independent to the Department of Health who would have the power to act on complains and enter hospital facilities for the purpose of investigating a complaint.
In its rejection, the state cited existing mechanisms that address issues of bullying and harassment within hospitals and health services.
Other recommendations included in the Ministerial Review involved opening up training opportunities for regional GPs to upskill in paediatrics, palliative care, mental health and emergency medicine.
