Data on the specialist pathway for international medical graduates does not appear to support the government’s case for taking selection out of college hands.
The AMA has now joined in the chorus of dissenting voices on the government’s plan to open up a fast-track registration pathway for overseas-trained doctors, as new data supports medical college efficiency.
If implemented, the new pathway would allow graduates with “substantially equivalent” overseas qualifications to go straight to the board for specialist registration, rather than going through a specialist college process.
This would cut out a lot of time and bureaucracy, but it would also mean less i-dotting and t-crossing prior to registration.
When the proposal was first revealed in April, it came as a big surprise to the medical colleges, who will stand to lose a potentially sizeable portion of examination and membership fees.
This week, the AMA told the Department of Health and Aged Care that while it was supportive of efforts to streamline the pathway for overseas-trained specialists, it was “fundamental to our system” that the colleges continued to set standards for training and education.
Adding extra spice to this situation is the extremely compressed timeframe demanded by health ministers, who intend to have the expedited pathway up and running for general practice by October.
“The rapid timeframe dictated by health ministers for achieving this outcome is unrealistic and does not allow sufficient time for proper consideration of all the issues involved in what are very significant changes,” the AMA submission read.
Other issues it brought up were the fact that reducing the regulatory burden and hurdles would not actually integrate internationally trained doctors into the Australian health system.
Migrant doctors would still have a lack of access to personal supports, education and training, would still be forced into exploitative contracts and would still face racism from patients and colleagues.
What’s more, it would likely create a new backlog of work.
“The new SIMG pathway will increase the workload of the Medical Board as it will begin receiving and processing applications for SIMGs to work in Australia,” the association said.
“The AMA has been frustrated that the costs of the reforms to date have been borne by doctors and other registered health professionals through their AHPRA registration fees.”
It challenged DoHAC to find appropriate funding for this work, “particularly as it is a result of the lack of investment and deliberate decisions to withdraw health workforce infrastructure”.
The regulator, meanwhile, has released a new report breaking down the medical colleges’ specialist pathway data.
While it is true that internationally trained specialists spend the longest period of their path to registration fulfilling college-mandated requirements – the rest of the registration process tends to be efficient – delays are not always the fault of the college.
In fact, in terms of compliance with benchmark timeframes, colleges were pretty good.
Across the 13 colleges that provide hopefuls with a summary of preliminary review – basically a letter showing where the internationally-trained doctor falls in relation to individual college standards – before conducting an interview, 90% were sent within the 21-day benchmark timeframe.
The main offender was the Royal Australian and New Zealand College of Psychiatry, which took more than 22 days to send its reviews to about half of applicants.
For the next step, the interview, 85% of doctors received their offer within the standard four-month timeframe from submission.
Again, a minority of colleges caused the majority of offending.
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The Australasian College of Dermatology made all but one of its 16 applicants wait more than six months for interview and RANZCOG failed to make the four-month timeframe for 25 out of 46 applicants.
RACS, the College of Intensive Care Medicine, the Australian and New Zealand College of Anaesthetists and the psychiatry college all failed to meet the benchmark for one or two candidates.
Every college met the compliance measure for the period of supervised practice required for substantially or partially comparable internationally trained doctors.
Only a small number of doctors relative to the number of applicants seek a review or appeal their assessment decisions, and those that do tend to be appealing the level of comparability they were granted.
