Doorstop Interview with AMA Vice President, Dr Mukesh Haikerwal, Monday 5 July 2004
Discussion: Overseas Trained Doctors
E & OE - PROOF ONLY
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QUESTION: Just a general comment about the report firstly. Do you agree with what its main findings are?
HAIKERWAL: The AMA's response to the report from Monash University is that it concurred with many of the findings we ourselves have had, looking at the issues surrounding the employment of overseas trained doctors in Australia.
We are concerned that people are entering the system without some degree of credentials. They aren't being supported into the system. They're not getting proper cultural orientation, that they're not getting up to speed in English. And certainly that they are understanding the system itself is also quite poor. It's very important that all those things are taken into account when going on and employing people from overseas.
QUESTION: What do you think is behind this? Because the implication in the Monash report is that it's partly to do with denial over time that there was actually a doctor shortage.
HAIKERWAL: The workforce agency that produced a report years ago has now actually been discounted. And what we're seeing is a new workforce is underway. And what we've found is that every single speciality in Australia is under-supplied bar one. And it's very important that we understand we are in a position of workforce shortage. By shutting down many of the avenues of people getting into training in 1996 has actually exacerbated the situation that we have - that we have a workforce shortage and people are having a great deal of difficulty getting access to medical services.
QUESTION: So do you think that the situation then is appropriate because the other implication in the report is that perhaps a certain sector of the community is getting a level of care that is not the same as metropolitan areas?
HAIKERWAL: Look, it's absolutely essential that if anybody is working within the Australian context and looking after patients, those patients are entitled to expect the same quality and calibre of care that they would get anywhere in the country. And that's a very reasonable expectation. What's happening, of course, is that people may be entering the workforce without reaching the Australian Medical Council guidelines.
There's no real monitoring of specialists by the specialist colleges of some of these folk because that's just not something that they do. And it is important that that work is done. That people working are mentored and oriented as they should be so they can work competently. And that should be monitored by the colleges and certainly by the medical council and even the medical boards.
QUESTION: So how seriously should the public be taking this? Because on the face of it it's a bit of a worry to think that people are entering the profession if they're not appropriately qualified.
HAIKERWAL: Look, it's important that we advocate quite long and hard about this. It's important people understand the need for medical care. But also that care needs to be of a sufficient quality and standard that would be expected. So people who are coming in from overseas and they will be the pick of the crop of their own medical schools, they've had to go through very stringent requirements to actually get into medical school.
So these people are of medical standards but they may not be appropriate culturally, they may not have quite made the same grades as we would expect within Australia. And they need to be brought up to speed. We also need to make sure that they are oriented both for language as well as for the culture in which they're working, and make sure that they understand the system. And that's really a requirement I would hope of the recruitment agencies.
Some recruitment agencies, the good ones certainly do that sort of work. And we think that that's actually important for them to look after the people that they bring into the country. Treat them well and make sure that they're settling into their new roles. That would keep them in the country long-term, so you haven't got the revolving door of people coming in and people going, in the short-term. And that would sort of stabilise the situation.
The other part of your question is that in the population there are about 3000, 3500 doctors who qualified overseas who are here legally, migrants with citizenship and some with permanent residency who actually have much more stringent requirements of them to work their way through the system.
We would agree that this is a very valuable source of medical manpower, that if we were to tap into by allowing access to bridging courses and get them across the line. We don't want to lower the hurdle, we want the hurdle to be the same. We want to help people across it so they can make the grade, make the cut and then be integrated into the medical practice in the country long-term.
QUESTION: Yes, because there's perhaps a danger that people on temporary visas could be seen as exploiting some sort of loophole. Yet those with permanency can't work.
HAIKERWAL: Well, that's exactly right. I mean, the immigration status of people has thrown quite a lot of disarray ... thrown the system into quite a lot of disarray because there are so many complex ways of accessing a place in the medical system.
But really it needs to be streamlined, it needs to be made much more clear, there needs to be accountability from government as the overall group responsible, whether it's federal from an immigration point of view, state from an employment point of view.
From the medical colleges, from a competency point of view, and from at the AMA to make sure that all doctors are looked after and actually made the grade that is expected of them and aren't left in an untenable position. It's not safe for them but most importantly it's not safe for their patients.
QUESTION: So could I get you to put it in a nutshell, I know the AMA is doing its own report.
HAIKERWAL: In a nutshell, the AMA's position regarding this report is one of actually accepting many of its findings. It's very similar to what we ourselves have found. It's important that we have people working in Australia that are competent, medically, that have been oriented and are mentored through to make sure that they are both sensitive to the environment in which they are working, understand...because their language is up to speed, and understand the culture in which they're working, which has to be, which does require specific training. And I think that' something that we at the AMA will be pursuing in the next few weeks and months.
Ends