Australia’s state health ministers have been warned that the proposed fast-track registration of Specialist International Medical Graduates (SIMGs) risks exacerbating a two-tier healthcare system in which the quality of specialist care is determined by a person’s postcode.
The warning came from the Council of Presidents of Medical Colleges (CPMC) ahead of the 6 December meeting of health ministers.
Ophthalmologists and their representative bodies will be watching developments with interest.
If approved they are likely to be included in 2025, in a new scheme that fast-tracks registration of overseas specialists into Australia and bypasses traditional vetting by medical colleges.
Both RANZCO and the ASO have come out with concerns about that, and fears that any new specialists will simply end up working in the country’s major cities, exacerbating workforce and health access issues in the regions and rural centres.
Associate Professor Sanjay Jeganathan, chair of the CPMC board, said: “As health ministers prepare to meet on December 6, 2024, we urge them to carefully consider the long-term implications of rushing registration processes and creating different standards for different regions.”
“The current proposal effectively creates two classes of specialist registration – one for metropolitan areas and another for everyone else,” he said.
The CPMC has highlighted concerns about the fast-tracking of international medical graduates:
– Reduced supervision requirements for newly registered international specialists under the new scheme.
– Shortened assessment processes that will not fully evaluate clinical competency.
– Limited oversight of the scope of practice in regional settings.
– Insufficient support structures for international medical graduates in regional placements.
– Lack of clear continuing professional development frameworks.
– No clear mechanism to ensure international medical graduates go to areas of greatest need.
“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,” said A/Prof Jeganathan.
“Creating rushed registration processes doesn’t help anyone – not the communities they serve, and certainly not the international specialists themselves.”
The CPMC has called for health ministers to address:
- Maintaining consistent specialist registration standards nationwide while improving the efficiency of current assessment pathways.
- Establishing adequately resourced support systems for international medical graduates in regional placements.
- Creating clear frameworks for supervision and scope of practice.
- Developing structured transition programs for international specialists.
- Implementing robust quality assurance measures for all registration pathways.
- Strengthening mechanisms to direct specialists to areas of genuine workforce shortage.
“The promise to strengthen Medicare must not come at the cost of compromising our medical standards,” said A/Prof Jeganathan.
“We need sustainable solutions that support international specialists to meet our high standards, not shortcuts that risk patient safety and professional standards.”
The CPMC and its member colleges are keen to work with state and federal governments to safely implement this program and propose alternative solutions, including:
– Enhanced support and mentoring programs for international medical graduates via specialist medical colleges.
– Improved assessment efficiency without compromising standards.
– Better integration of international medical graduates into existing specialist networks.
– Structured professional development programs.
“Every Australian deserves access to fully qualified specialists who meet our world-class standards,” said A/Prof Jeganathan.
“Creating different standards for different regions isn’t the answer to our workforce challenges – and prior failed programs have shown it will exacerbate existing institutionalised inequality in healthcare delivery.”
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