The Council of Presidents of Medical Colleges is calling on health ministers to rethink the fast-tracked specialist international medical graduate registration pathway.
The Council of Presidents of Medical Colleges is calling for the scope of practice of doctors approved through the fast-tracked specialist international medical graduate pathway to be limited, amid concerns for safety and long-term implications.
The controversial new fast-tracked pathway took the medical colleges by surprise when it was first announced in April this year.
Successful applicants will only have to undertake six months of supervised practice, cultural safety education and an orientation to the Australian healthcare system.
The pathway opened for GPs in October and is set to open for anaesthetists, psychiatrists, obstetricians and gynaecologists by the end of this month.
Effectively, it allows overseas trained doctors who have completed specialty fellowship in countries with substantially similar programs – namely the UK, NZ and Ireland – to bypass medical colleges and go straight to the board to obtain Australian registration.
Many medical colleges have voiced concerns over a lack of information or clear plan for the pathway and supervision.
Today, the CPMC is calling on the Heath Ministers, ahead of their meeting on Friday, to heed its concerns.
“We urge them to carefully consider the long-term implications of rushing registration processes and creating different standards for different regions,” said CPMC chair Associate Professor Sanjay Jeganathan.
“The current proposal effectively creates two classes of specialist registration – one for metropolitan areas and another for everyone else.
“International medical graduates have long been vital to Australian healthcare, but they deserve proper support and assessment pathways that ensure they can practice to their full potential.
“Creating rushed registration processes doesn’t help anyone – not the communities they serve, and certainly not the international specialists themselves.”
The Council’s major concerns over the pathway include the limited six-month supervision requirement, lack of oversight of scope of practice in regional settings, a lack of clarity around who will provide supervision and no effective method to address workforce maldistribution.
Speaking to The Medical Republic, Professor Jeganathan said that the Council was not looking to stop the expedited pathway, which is already in motion for GPs, but called for discussion and deliberation over how to deliver the pathway safely.
He said that despite only having been open for a matter of weeks, from his understanding, around 70 GPs had already been approved or were in the process of being approved through the pathway.
Related
Inconsistency in clinical competency was a major concern for the Council.
Professor Jeganathan said that each specialty had specific concerns regarding the incomparability of qualification.
“For example, UK dermatologists are not trained to the level of Australian dermatologists in terms of melanoma,” he said.
“[An] example in my field of radiology, UK radiologists are not trained in imagery for pregnant women, and that’s bread and butter for us.”
Professor Jeganathan said currently there were no clear mechanisms for training for specialist overseas doctors in this pathway, as it was historically a job for colleges.
“We have asked for SIMGs coming through this pathway to have restricted scope of practice based on the recency of their practice,” he said.
“If you take me as an example … as a radiologist, my registration allows me to work in a vast variety of radiology reporting, but for the past five years, I have not done any brain MRI reporting or spine MRI reporting.
“Now, if I’m coming into a new country with a new blanket registration given as a specialist, I am able to report them, there are no restrictions.
“There should be some kind of restricted scope of practice.”
Professor Jeganathan said it also remained unclear who would be supervising these doctors, as, again, this was historically the responsibility of the colleges.
He said he would be surprised if the colleges continued to be involved in supervision for the pathways, as they had no visibility into the process.
“The Medical Board’s view is [their] role is to register the doctors and then leave it to the market to dictate what is safe and what is appropriate.”
Speaking to TMR, GP Supervision Australia CEO Carla Taylor said the organisation was keen to create a framework for the supervisors of these fast-tracked doctors.
Professor Jeganathan added that the fast-tracked pathway lacked a suitable method to encourage the newly registered doctors to work where they were most needed.
“The only mechanism the federal government points to is the [10-year] moratorium on Medicare provider numbers that’s only allowed for MM2-MM7.
“We know that has not worked in the past, within two or three years all the SIMGS find ways to trek to the Big Smoke.”
Professor Jeganathan said there were a number of regulatory or legislative mechanisms that could target maldistribution, such as tax concessions.
