Fast track for internationally trained medical specialists

The Medical Board of Australia has announced a new process to safely fast-track urgently needed internationally trained medical specialists into the country’s health system, following its annual board meeting.

Delivering the plenary address at the meeting in Adelaide, Australia’s former Chief Medical Officer, Professor Brendan Murphy AC, said the expedited specialist pathway being developed by the board and Ahpra was “essential”.

“We do have health workforce shortages in Australia… but as always, the shortages in the medical workforce are not evenly distributed geographically or among medical specialists,” Murphy said.

“Despite the return to pre-COVID migration levels, the shortages persist without clear evidence that the Australian training pipeline of doctors will resolve them anytime soon.

Consultations underway

The process — aimed at getting more medical specialists face to face with patients — will initially prioritise GPs, anaesthetists, obstetricians and gynaecologists, and psychiatrists (in line with jurisdictional priorities), and will sit alongside the existing specialist medical college assessment system.

Consultation with specialist colleges is underway to identify the comparable overseas specialist qualifications that will open access to the new pathway, which will sit alongside the existing specialist medical college assessment system.

The new process — a fast-track registration pathway — will recognise specific overseas specialist medical qualifications and grant upfront specialist registration to eligible doctors. Initial conditions on their registration will be imposed as a safeguard to protect patients while the new recruits are inducted into Australia’s healthcare system.

“This is an international marketplace where we must be competitive, and we must be attractive to those doctors and other healthcare professionals who might want to come here,” Murphy said.

“For those doctors who are currently in the process of migrating, we should be doing everything possible to get them into clinical practice as soon as it is safe. We should do what we can to make migration to Australia attractive for those doctors who we really need to fill critical shortages in critical locations and specialties including, if necessary, subsidising some of the costs,” he said.

Regulatory reform

National Cabinet has put regulatory reform squarely in the sights of Ahpra and the Medical Board and set an ambitious timeline for action on the recommendations of the Kruk review, this month’s annual gathering of more than 150 medical regulators and staff nationwide was told.

The Kruk review explicitly recommended the creation of an alternative fast-track pathway to specialist registration for eligible medical specialists from countries with comparable healthcare systems.

Ahpra and the board have set up a taskforce to develop the new expedited pathway and the board is now consulting with the specialist colleges for the priority medical specialties to finalise the list of qualifications that will be the gateway to fast-track registration.

Discussions with the RACGP, ACCRM, ANZCA, RANZCOG and RANZCP are underway to determine which qualifications have consistently been assessed as comparable in existing college approval processes, as the basis of the new expedited process.

An additional route to registration

Medical Board member and lead on the board’s Specialist IMG taskforce, Dr Susan O’Dwyer, said the new fast-track pathway would be an additional route to registration for IMGs with specialist qualifications.

“Specific qualifications would be validated and become part of a published list of eligible qualifications and, if an SIMG has a qualification on the list, they would not need to apply to the college for an assessment of their qualification,” O’Dwyer said.

“They would instead apply directly to the Medical Board for specialist registration.

“Under the proposal, they would then work as a specialist under supervision for six months and complete Medical Board requirements such as cultural safety and orientation to the Australian healthcare system.

“Once the requirements are completed satisfactorily, they would be granted unconditional specialist registration,” O’Dwyer said.

The board will consult on the registration standard being used as the regulatory tool for the new pathway, before final review and approval by health ministers.

Fellowship of a specialist medical college will not be an automatic outcome of the new expedited pathway, but the board was working with all specialist colleges through a specifically constituted SIMG advisory council to explore the implications of this and possible solutions.

Target start dates

To meet government expectations, the board and Ahpra have targeted an October 2024 start date for the expedited specialist pathway for general practice, and December 2024 for an expedited pathway for anaesthetics, obstetrics and gynaecology, and psychiatry. As a result, consultation timelines on updated registration standards and other necessary policy changes will be compressed.

“The board is pulling out all stops to create a safe and effective policy platform and make the necessary complex operational changes to meet these deadlines and get more medical specialists at work in Australia quickly,” O’Dwyer told delegates.

“The key message from this review is that removing outdated regulatory barriers faced by internationally qualified health practitioners will improve care for Australians,” O’Dwyer said.

“The goals of an expedited pathway would be to have more well-qualified, specialist IMGs to better meet the Australian community’s medical needs with quicker specialist registration for qualified and competent SIMGs and with fewer barriers.

“There should be greater certainty for specialist international medical graduates that they will be registered and able to practise in their specialty, making Australia a more desirable destination.”

Not a long-term solution

While reforms involving National Boards to attract and register skilled international practitioners were vital to address Australia’s post-COVID healthcare needs, Murphy stressed that enhanced migration was not a long-term solution to the pressures confronting the nation’s health systems.

“There is a material risk in my view that the ‘sugar hit’ of a migration boost will be seen as easier than the necessary reforms to the training and distribution of Australian trained doctors,” he said.

“These require us to, once again, focus on implementing the National Medical Workforce Strategy, including its important self-sufficiency goal.”

Image caption: iStock.com/Nikada