Hydra Healthcare

Full Australian Medical Council submission at http://bit.ly/hM8kKo 

House of Representatives Standing Committee on Health and Ageing Inquiry into Registration and Support Processes for Overseas Trained Doctors

Summary of Assessment and Registration Processes
• Under the federal system of government in Australia the registration of medical practitioners was a state responsibility until July 2010. In addition to the examination administered by the AMC, each state had its own legislation, policies and processes for the assessment and registration of medical practitioners. From July 2010 a single national registration system was implemented for 11 health professions, including medicine.

• In 2006 the Council of Australian Governments (COAG), in anticipation of the national registration developments, announced a project to implement nationally consistent approaches to the assessment of International Medical Graduates (IMGs).

• Currently there are three general categories of registration available to IMGs:
– Full non-specialist or general registration – independent practice in all fields of medicine
– Registration as a specialist – independent practice in an approved field of specialty
– Limited registration (specialist and non-specialist) – practice under supervision which may be limited in scope, duration or location

• A number of assessment pathways have been established to enable IMGs to obtain these categories of registration:
– For non-specialists seeking general registration there are three AMC administered assessment pathways:
~ Standard pathway AMC examination (MCQ test of medical knowledge plus clinical examination)
~ Standard pathway Workplace-based Assessment (MCQ test of medical knowledge plus accredited workplace-based assessment) – still in a development / pilot stage
~ Competent Authority assessment (Recognition of prior examination/training plus accredited workplace-based performance assessment in Australia.)

– For overseas trained specialists there are two assessment pathways administered by the relevant Specialist Medical Colleges:
~ Assessment for full recognition – applicant assessed against the standards for an Australian trained specialist in the same field of specialty
~ Area of Need (limited) Registration – applicant assessed against a position description (required skills) for the relevant area of need post.
 

– In addition to the assessment pathways, all IMGs seeking registration must satisfy the following additional requirements:
~ Since 2005 all IMGs must satisfy English language proficiency requirements set by the Medical Boards (adopted by the Medical Board of Australia from July 2010). There are two principal tests:
1. the Occupational English Test (administered in Australia under the auspices of the University of Melbourne)
2. The International English Language Test (IELTS) administered by the University of Cambridge and the British Council.
[It should be noted that the AMC does not conduct any English language proficiency tests. Nor does it set the standard for these tests.]

~ Since 2006 all IMGs have been required to have their qualification independently verified through the Primary Source Verification Process administered on behalf of Medical Boards by the AMC.

– In the case of Area of Need registration, the Medical Board may determine that an IMG must satisfy a Pre-Employment Structured Clinical Interview (PESCI) to enable the Board to establish whether the applicant has the required skills set for a particular position and to determine any conditions that might be imposed on the registration for then purposes of patient safety.

• Since July 2010 the Australian Medical Council, as the designated accreditation authority for medicine, has administered the assessment of IMGs for non-specialist medical registration on behalf of the Medical Board of Australia under the provisions of Section 43 of the Health Practitioner Regulation National Law Act 2009. Similarly, the Specialist Medical Colleges have been individually appointed by the Medical Board of Australia as the appropriate authorities for the assessment of overseas trained specialists under the provisions of Sections 57 and 59 of the National Law Act 2009. As the designated authorities the AMC and the Specialist Medical Colleges are accountable to the Medical Board of Australia for the conduct of these assessments.

• There is extensive documentation available of the AMC website and on the websites of the Specialists Medical Colleges and the Australian Health Practitioners Regulation Agency (Medical Board of Australia) regarding the assessment processes and registration requirements for IMGs in Australia.

• In addition to the information regarding assessment procedures, the AMC has produced a series of reference texts for IMGs undertaking the AMC examination which provide comprehensive information about the content of the AMC examinations, sample self-test examinations and commentaries on clinical best practice in the Australian clinical context. Australia is the only country with screening examinations for registration purposes that provides this level of information to assist IMGs.

• The assessment and registration provisions for IMGs are complex and, in the past, have been difficult to navigate. The assessment processes can be very stressful for the individual applicant and the time delays in completing the processes frustrating. Nevertheless, the assessment and registration of medical practitioners is a high stakes process where individual failures, as evidenced in the Patel case in Queensland, can be very costly to the Australian community.

• The assessment initiatives and regulatory reform agenda initiated by COAG in 2006 have themselves been complex and difficult to implement. The AMC considers that the establishment of the Medical Board of Australia provides a genuine opportunity to establish consistent national policies and practices for the assessment and registration of IMGs.

Australian Medical Council
18 March 2011