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Overseas practitioners: English language proficiency and ‘recognised countries’ under microscope

To make Australia a more attractive destination for overseas-trained practitioners, Ahpra and the National Boards are considering two additional changes to English language skills (ELS) requirements that could see the bar lowered for writing proficiency and the list of “recognised countries” significantly expanded. 

The two new proposals follow an independent review, led by Ms Robyn Kruk, to cut the red tape and costs for qualified overseas-trained practitioners wanting to work in the Australian health system. If introduced, the measures could alleviate workforce shortages in regional areas that have struggled especially when it comes to specialist eyecare services. According to a 2018 workforce report, ophthalmology welcomes around 12 overseas trained new fellows each year. 

The Kruk review recommends measures to immediately boost the health workforce and ensure Australia is a competitive destination for the global health workforce, while weighing these against quality and safety.

According to the report, employers and health practitioners say Australia’s registration and immigration processes are often slower, more complex and expensive than other countries. For example, recruiting an overseas GP can take up to 21 months and cost more than $25,000 even for cohorts from fast-tracked countries, while nurses can pay over $20,000 and take 35 months to get their qualifications recognised.

“Only applicants with qualifications from a small number of countries and professions are eligible for the streamlined pathways,” Kruk said.

“The requirements are particularly inflexible for experienced health practitioners that specialise over their career. Regulatory responsibilities are highly fragmented, with roles spread across multiple parties and legislation with little coordination. Some employers no longer consider applicants from countries without expedited registration pathways as the process is too hard and outcomes uncertain. Australia is often no longer the country of choice for the health workers we want and need.”

One significant proposal raised early on in the consultation was to remove South Africa from the list of English-speaking “recognised countries”. This classification typically offers a smoother path to registration if practitioners have completed their education and qualifications there. This is because of inconsistencies in English language standards across health professions in South Africa, with some substantially below the equivalent Australian entry requirement.

Ahpra also considered making Hong Kong, Malaysia or Singapore recognised countries, but could not find sufficient evidence to do so. If South Africa is removed, the remaining recognised countries would be Australia, Canada, New Zealand, the Republic of Ireland, UK and US.

But the Kruk report noted that often practitioners from countries with similar regulatory systems to Australia must sit exams or undertake further training to qualify, adding costs and delays. Many are also subject to long periods of supervision despite having extensive clinical experience.

Now, Ahpra and National Boards are considering expanding the list of recognised countries after a review indicated opportunities to expand the recognised country list to better align with UK and NZ.

There are 24 countries on the proposed list, many of which are Commonwealth countries or self-governing British Crown dependencies such as Jamacia, Barbados, Guernsey, Isle of Man, Jamaica and Malta. 

In another move focused on English language proficiency, the regulator is also considering setting the minimum requirements for the writing component of an English language test from seven to 6.5 IELTS equivalent and seven in each of the other three components (reading, speaking and listening) with an overall score requirements of seven. 

According to Kruk, this change could improve the success rate from 26% to 40% of test takers, saving candidates time, costs and the need to sit multiple tests. It could also led to an additional 2,750 health practitionerd registered over five years.  

More reading

Registration requirements slashed for international practitioners

Doubling of international health practitioners registered in Australia

Review to fast-track overseas-trained practitioners into stretched Australian health system

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