http://www.smh.com.au/articles/2004/...879374510.html
Warning on gaps in doctor training
By Mark Metherell, Political Correspondent
July 5, 2004
Three thousand foreign-trained doctors are practising
in Australia without having been subject to normal
medical exams that many of them would probably fail,
according to research published today.
The provisionally registered doctors, recruited by
state governments to serve in areas of need, do not
have to sit the rigorous tests required of others -
and their numbers are ballooning because of critical
shortages, particularly in rural Australia.
The study warns that the Government's MedicarePlus
plans to recruit 1500 more overseas-trained doctors
places further pressure on the system.
Exam results showed that just over half the doctors,
including repeat candidates, passed the Australian
medical exams set for overseas-qualified doctors
seeking to practise here.
But there has been no systematic assessment of the
capacity of the provisionally registered doctors who
have not sat the tests, researchers Bob Birrell and
Lesleyanne Hawthorne say.
There were several thousand temporary resident doctors
practising in Australia, "an increasing minority of
whom may not have experienced a training program
equivalent to that prescribed for local doctors", they
say in an article in People and Place journal,
published by Monash University's Centre for Population
and Urban Research. "Very few have had to undergo
rigorous examination of their skills prior to practice
commencement. An increasing proportion is coming from
nations where the training programs are not tailored
to the health-profile characteristics of Australian
patients."
Dr Birrell, the head of the research centre, declined
yesterday to detail any instances where
overseas-trained doctors had been implicated in
medical misadventures because of training
deficiencies. But he said he had been told such
doctors tended to need more supervision and there was
an official reluctance to allow them to practise
independently.
According to Australian Medical Council exam figures
cited in the study, graduates from one of the biggest
source countries, India, had a 47 per cent pass rate
on a theoretical test and 63 per cent pass rate on
clinical. Another large group, from Bangladesh, scored
an 80 per cent pass rate on theory but 48 per cent on
clinical.
These exams were sat by medical graduates already in
Australia and it is an issue of aggravation to them
that state health departments have focused on
recruiting doctors directly from overseas who can take
up temporary medical appointments without having to
pass an equivalent test, the researchers say. Out of
Australia's 25,000 non-specialist doctors, 3000 or
more are overseas doctors in training, or practising
under provisional registration, the study says.
The federal and state governments have been tardy in
committing the money to fill the gaps in supply by
providing the bridging and other training for overseas
graduates already living in Australia, the researchers
say.
The Australian Medical Association has voiced concerns
about excessive reliance on overseas-trained doctors
and the difficulties some face when thrown into
service in remote communities, but there had been no
sustained campaign on the issue, they note.
A spokesman for the federal Health Minister, Tony
Abbott, said he was concerned that all practising
doctors met registration requirements but the issue
was in the hands of state medical boards.
The NSW Government had provisionally registered the
doctors without exams in order to provide urgently
needed doctors to areas of shortage, said a spokesman
for the NSW Health Minister, Morris Iemma. The foreign
candidates for areas of need did have to satisfy the
Medical Registration Board they were appropriately
qualified for their position, he said. Once appointed,
they were supervised by their medical college and
required to undertake continuing training.