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Posted on 10 Feb 2012 10:13 pm
As a Queensland resident and Managing Partner of YOU Global, a global recruitment company with an interest in sourcing human medical resources globally for supply to the Australian medical sector, there are several issues which I feel need a good look at by the politicians who have the power to make some changes:
1. If Australia has an appetite for overseas quality medical specialists due to a shortage in homegrown supply, even if to combat brain drain, why on earth do we have a scenario whereby an overseas specialist must pay around AUD 8,000 to the relevant medical College, even before the specialist will be assessed? This is crazy. Australia should be doing all in its power to attract such talent. Telling an interested specialist "first pay AUD 8,000 and only THEN shall we confirm whether you can work in Austraila" is discouraging to say the least.
I do understand that the Colleges are privately run institutions which have financial bottom lines to consider, but the answer to the Colleges' bottom lines, and the shortage of specialists in Australia, is not to impose an application fee on the specialists we desperately need. The public purse should be funding the costs incurred by the Colleges. Or perhaps the incoming specialist be obliged to pay back the cost but only once gainfully employed within Australia. There are a range of solutions, but charging a non refundable assessment fee of such a large amount is not the answer. That cost is just the start - the Candidate then has to fund airfares for face-to-face interviews, accommodation, lost opportunity in terms of time away from work, visas, and a whole range of ancillary expenses.
Quite different if Australia has other options, but my understanding is that we desperately need the resources.
2. Australia has charged the Australian Medical Council (AMC) with the task of preliminary assessment of International Medical Graduates (IMGs) via the AMC's Computer Adaptive Test (CAT) Multiple Choice Questionnaire (MCQ). If an IMG passes the MCQ, this effectively gives the IMG license to apply for Medical Board registration, and then apply for a visa into Australia.
The reality is, Australia has LOTS of IMGs who have been down this path, passed the MCQ, have obtained Australian residency, but cannot get a job, even in regional areas, despite Australia screaming out for doctors.
Australia has in a way encouraged IMGs to jump through the many hoops which it throws up, to incur the many expenses, and at the end of the race, the IMG can't get a job. It's almost a case of misleading & deceptive conduct.
I've given plenty of thought as to why this ludicrous situation exists. It seems to be about the rules and regulations surrounding employment of an IMG. Despite the AMC stating, by virtue of an MCQ being passed, that an IMG is considered technically proficient to practice medicine within Australia, albeit on a supervised basis, the onus on the employer is so extensive that employers steer clear of limited-registration IMGs. I have a situation right now whereby a Queesnland practice, in an Area of Need mind you, cannot employ an IMG because it lacks sufficient resources to meet the supervisory requirements laid down by AHPRA.
There are surely more effective ways to put these IMGs to good use, give them the jobs that they want, without bottlenecking the process by imposing impossible requirements on the employer.
3. Here's another example of a system which is marred by head-scratching outcomes.
We had an Australian-resident IMG who had taken the trouble of not only passing the AMC MCQ, but under advice had gone to the extent of passing the Clinical Examination as well. The was BEFORE finding a job, presumably because he thought that going that extra mile would improve his prospects.
We had a vacancy, within a Queensland Area of Need, for which the IMG was considered suitable by the prospective employer. However, because the IMG had passed the Clinical Examination, he had inadvertently struck out his ability to be granted limited registration via AHPRA. Therefore he could not be employed. No explanation from AHPRA, that's just the way it is. In other words, an Area of Need in regional Queensland goes without because the doctor has overachieved in his attempts to secure employment.
By passing the Clinical Examination, this doctor had unknowingly restricted himself to being employed initially only by hospitals on a 12-month rotational basis. He had decreased his prospects of employment by gaining further education. How does that make Australia look on the world map?
4. Quite simply, there are way too many fingers in the pie, none with the authority to solve problems, for the Australian health system to effectively and efficiently take in IMGs to solve the undersupply of medical professionals.
Let's see, who has a say in the overall process? There's the AMC (which at times I can't even get through to), ACRRM (charged with undertaking PESCIs), the various Colleges some with both national and State committees, the Medical Board, AHPRA, State health departments, federal health authorities (Medicare and the issue of provider numbers), and the Department of Immigration. I've probably missed some.
Sure, Austraila needs to protect itself from rogue doctors, but surely we're missing out on quality talent because of the Mt Everest-scale challenges we put up for doctors to consider coming to Australia to work. Australia places the onus on the IMG to navigate his or her way through this complex (and expensive!) landscape. These guys are medical specialists, and most IMGs work much longer hours in their home country than the working hours we're accustomed to in Australia, even by your average Australian doctor's standards. Only the most tenacious IMG will have the energy to make it all the way through, and therefore much-needed medical talent never makes it to Australia.
If Austraila has an inability to come up with a system which substantially reduces the red tape and bureaucracy, which reduces costs and timeframes, then let Australia suffer its own inadequacies. Don't impose these shortcomings onto the talent which Austraila needs. As an easy first step towards solving the problem, Australia needs a single point of contact for an IMG. The IMGs should not have to interact with the AMC, employers, ACRMM (for PESCI), medical Colleges, AHPRA, the Department of Immigration, Medicare, and maybe others, when he or she may not have even stepped foot in the country. We need to promote seamless integration.
5. The costs of the whole process is prohibitive enough, but another thing. Free cross-platform video conferencing, such as Skype, is omnipresent in the world today, and has been for some years.
Why does Australia make IMGs run off to a costly video conferencing centre, in order to access expensive and proprietary video conferencing equipment, just for a 90-minute PESCI? Not only does the IMG incur cost in the home country, but we make the IMG pay for the rent of the video conferencing facility at the Australian end. This is plainly unnecessary, and is testament to the lack of high level smart project management that has gone into creation of the current mess represented by the process of an IMG securing employment in Australia.
BCom (Bkg & Fin), JP(Qual), F Fin
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