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Australia launches inquiry into treatment of overseas trained doctors

BMJ 2010; 341 doi: (Published 25 November 2010) Cite this as: BMJ 2010;341:c6780
  1. Ray Moynihan
  1. 1Byron Bay, Australia

A parliamentary inquiry in Australia launched this week will examine whether registration processes for overseas trained doctors could be improved, after calls for a public review from the Australian Doctors Trained Overseas Association.

The announcement of an inquiry follows mounting public concern in Australia that new assessment procedures may have been causing unfair deregistrations of some overseas born doctors working in areas of high need.

Those procedures were introduced in the wake of the long-running Jayant Patel case, the foreign trained surgeon recently jailed in Australia after being found guilty of manslaughter.

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

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

Earlier this month the body responsible for registration—the Medical Board of Australia—announced it would conduct a limited review of whether the new system was being effectively implemented and how it could be improved. Chair of the medical board Joanna Flynn told BMJ the internal review “will make sure processes are working, and that we’ve got consistent national standards.” On the specific question of the interview based tool being used to assess overseas-trained doctors, Dr Flynn told the BMJ its use would be temporarily suspended while the review was underway.

The Australian Doctors Trained Overseas Association argues the treatment of overseas born doctors has been “divisive, unfair, and discriminatory” and it welcomed this week’s announcement of a much broader parliamentary inquiry. “We don’t believe 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.

The parliamentary inquiry will look at how overseas-trained doctors could be better supported in seeking registration, and how to remove impediments to their full qualification to practise in Australia, “without lowering the necessary standards required by colleges and regulatory bodies.”

The inquiry’s announcement comes after the recent publication of a study in Medical Education (2010 doi:10.1111/j.1365-2923.2010.03769.x),which added some weight to concerns about Australia’s treatment of foreign born doctors.

Using an experimental design, researchers found Australians felt less favourably towards hiring doctors who were born in Pakistan compared with those born in Australia, even though the prospective candidates level of qualifications, education, work experience and personality profile were presented as similar. However, the bias on the basis of nationality was eliminated if the foreign born doctor had been trained in the United Kingdom.

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

Dr Flynn told the BMJ there was no evidence doctors were assessed for registration on the basis of their ethnicity.


Cite this as: BMJ 2010;341:c6780

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