Overseas trained doctors in Australia call for inquiry into registration system

BMJ 2012; 344 doi: (Published 18 January 2012) Cite this as: BMJ 2012;344:c6686
  1. Ray Moynihan
  1. 1Byron Bay, Australia

The Australian Doctors Trained Overseas Association is calling for a Senate inquiry into the system of registration and accreditation of doctors who trained outside Australia.

The call comes amid public concern that new assessment procedures may be causing unfair deregistrations of some doctors working in areas of high need, an issue raised last month in the Australian parliament.

The new procedures were introduced in the wake of the long running case of Jayant Patel, the foreign trained surgeon recently jailed in Australia after being found guilty of manslaughter (BMJ 2010;341:c3646, doi:10.1136/bmj.c3646).

Under the changes, introduced in 2008, the failure to pass a short interview based assessment can lead to deregistration of a foreign trained doctor working in Australia.

The vice president of the Australian Doctors Trained Overseas Association, Sue Douglas, said that the interview assessment is not a valid or reliable tool in such “high stakes” circumstances and that a growing number of doctors are being unfairly deregistered.

Earlier this month the body responsible for registration, the Medical Board of Australia, announced that it will review whether the new assessment system is being effectively implemented and whether it could be improved. The board’s chairwoman, Joanna Flynn, said that the review “will make sure processes are working and that we’ve got consistent national standards.”

On the specific question of the interview assessment of overseas trained doctors Dr Flynn told the BMJ that its use would be temporarily suspended while the review was under way.

While welcoming the temporary suspension, Dr Douglas argued that any inquiry should be far more wide ranging and be conducted by an external body such as the Senate.

“We don’t believe that a review by the existing authorities will lead to any kind of meaningful change,” said Dr Douglas, whose Canadian qualifications have not been fully recognised by Australian authorities.

In a related development, two weeks ago federal and state health ministers across Australia asked the nation’s Health Workforce Advisory Council for advice on how to manage the registration of overseas trained specialists, particularly those from countries with similar health systems.

The results of a recent study (Medical Education doi:10.1111/j.1365-2923.2010.03769.x) have also added weight to concerns about Australia’s treatment of foreign doctors. The researchers found that Australians felt less favourably towards hiring doctors who were born in Pakistan than those born in Australia, even though the prospective candidates’ qualifications, education, work experience, and personality profile were presented as similar. However, the bias was mitigated if the foreign born doctor had been trained in the United Kingdom.

Despite the small sample and effect sizes the researchers, from the University of Queensland, concluded that the results were tentative evidence of “discrimination against foreign born doctors,” a finding that Dr Douglas said validated her association’s concerns and the calls for a parliamentary inquiry.

Dr Flynn told the BMJ that there was no evidence that ethnicity was a factor in how doctors were assessed for registration.


Cite this as: BMJ 2010;341:c6686

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