Mobilizing the Doctor Workforce to Fight COVID-19 Should Include IMGs.

IMG doctor with face mask

With recent announcements, it appears that Australia has lost the initial attempt to tightly contain the spread of the coronavirus. Including reports that it is now starting to spread within the health workforce itself. There is a need to consider how we can develop plans to ensure that we have enough doctors, nurses, allied health and other important staff to cope with a predicted environment where there are increased cases of viral illnesses presenting to our health services and large amounts of staff either sick or in isolation.

It has been suggested that we will need to pull staff from some of the existing pools that we tend to rely upon to deal with shortages, such as locum or casual staff pools. But these sources are often already closely tapped. It has also been suggested that we may need to bring doctors and other health professionals back from leave or out of retirement. Which may help to an extent.

A Big Group of Doctors Has Not Been Thought About So Far.

What doesn't seem to have been considered so far is that there is another large group of doctors already in this country who are champing at the bit to get involved in helping with this potential increased demand on our health system.

There Are Literally Hundreds of IMGs Who Could Fill Basic Posts In Hospitals.

According to the latest sources from the Australian Medical Council, there were 660 international medical graduates vetted to commence supervised training posts, as part of what is called the standard pathway process, in 2019 by obtaining what is called the AMC Certificate (normally a 2-step examination process).

It is difficult to know exactly how many of these doctors have been able to obtain positions. As it is hard to get a link between those who obtained an AMC Certificate and registration status.

According to the Federal Governments workforce data set, I could only find data on the number of doctors who had completed the AMC process and been granted provisional registration for 2018. The number of completions was 862 and the number provisionally registered that year was 76. Now some of these doctors may have already obtained limited registration, for which there is no accessible data.

But I think it is reasonably safe to assume, given that the number will accumulate on a yearly basis, that we are talking hundreds if not over a thousand IMG doctors with an AMC Certificate who have not been able to obtain a position. The number of IMGs who contact me in these circumstances backs up this feeling.

There Are Also Quite a Few Specialist IMGs Who Could Help Out As Well.

Whilst the data from the Medical Board of Australia is a little bit older we know that in 2018 755 specialist IMG doctors were approved by medical colleges to commence supervised postings to work towards specialist recognition. Whilst in the same year only 614 specialist doctors were recommended or not recommended for specialist recognition. Whilst we are talking separate groups here (i.e. those at the start of the application versus those at the end), again anecdotally I am aware of many IMG specialists who have been granted approval to work as a specialist under supervision who have been now trying for a position for over 2 years.

So whilst the number of specialist IMGs who have been approved and are still waiting is likely to be far less than those on the standard pathway it is still likely to be in the hundreds of doctors.

Why Are These Doctors Not Employed Already?

The problem for most of these doctors is not their lack of competency or capability. This has already been assessed. It's just that there are limited available places for them and strong and stiff competition for them. When they do get a chance of a job they generally do very well. And are often willing to work in places and circumstances that locally trained doctors do not.

Many of these doctors would jump at the chance to work for 3 months to help out with our current emerging health system crisis.

Just to be clear, I am not talking about using or exploiting IMG doctors to help staff temporary virus clinics or our emergency rooms to save local doctors from being exposed. The most logical way to deploy this workforce would be to relieve or fill in for medical staff in regular roles, such as working on hospital wards to ensure that we are able to continue to manage the regular health needs of patients with other conditions.

What Would Need To Change To Make This Happen?

One of the big problems with getting IMGs up and running in positions in Australia has always been the bureaucracy involved. This includes paperwork to establish that they are not competing for a post with an Australian trained doctor, paperwork to satisfy the registration requirements and paperwork to obtain a working visa.

It is important that we maintain a certain standard of care in the registration requirements of doctors. But given that we are anticipating that there will be many vacancies at various levels in the system. It is reasonable to assume that many of these will be in posts that are supervised and supervisable for which an IMG doctor could be deployed.

Conversely, a system whereby such an IMG doctor could be more quickly be granted a short period of registration (say 3 months) would provide ease for the system but also reduce the risk of such a doctor not being supervised properly.

It would also then give the IMG actual experience in the Australian health care system, which is something that would tremendously help their resume and case for future employment opportunities.

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Anthony Llewellyn

Anthony Llewellyn

FRANZCP, MHA, GAICD | Medical HR Expert and Coach. Anthony is an experienced health public sector executive, medical educationalist and coach. Anthony is an expert in Medical HR. He has reviewed numerous CVs, chaired and conducted over a thousand job interviews and provided advice to a number of employers and Colleges about selection processes. Anthony's background: Consultant Psychiatrist and Medical Manager with 20 years’ experience as a medical practitioner in public health services in a range of roles. From 2012 to 2016, Anthony was the Medical Director of the Health Education & Training Institute (HETI), involved in overseeing a number of network training programs. He is also a Senior Lecturer at the University of Newcastle’s School of Medicine & Public Health, and Year 5 Psychiatry Coordinator. He is currently completing a PhD in Medical Education, exploring personal learning environments in the intern training space. Anthony recently delivered for the Royal Australasian College of Physicians a Best Practice Guide for Trainee Selection into Employment Roles Anthony was born on Mouheneenner land in Hobart (Tasmania) and pays respect to the traditional owners of lands he lives and works on, and elders past and present. His two most important roles in life are proud husband and proud father of two boys.

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