In the past, Australia has played a vital role in helping train doctors from developing countries in Asia and the Pacific where there’s often poor funding for medical training.
Now, Australia’s ability to support the training of these doctors is being undermined by safeguards introduced to protect patients from poorly-trained doctors from overseas.
There have been calls for Australia to find ways to support the training of these doctors in order to move towards health equality in the region.
Presenter: Sen Lam
Speaker: Professor Trevor Duke, director of the Centre for International Child Health and deputy director of intensive care at the Royal Children’s Hospital
- Windows Media
DUKE: In recent years the Australian government’s brought in a series of regulations; one is the high English language requirements that are needed by doctors to come to Australia. And the other is the Australian Medical Council exams. The major one is the English language requirement, and many of your listeners will be familiar with the IELT testing that is required, and that’s required whether you’re coming to Australia for a short-term training role for a year or two, or whether you’re coming to continue working for the rest of your career, to become a resident. So it’s the bureaucracy around those two requirements, the difficulty of overcoming those hurdles and the cost of doing so is obstructing this.
LAM: So aside from the cost of taking the test, do you think that the test standards are impossibly high?
DUKE: Well the test standards are very high. They’re not impossibly high because some people get through them, but most of the people who reach the English language requirements have invested often many years in English training in their own country, and they’ve invested a lot of money in English language training. I know many people who have wanted to come to Australia for a year for part of their training, their advanced training, and they’re competent English speakers, and yet they still haven’t been able to get the high level that’s required to the IELT’s testing, despite the fact that they’re coming to Australia to work in supervised training positions and that’s obstructed them coming.
LAM: So is there an overarching body if you like, a controlling body that decides who comes in, decides the standards of these tests, who makes these decisions?
DUKE: Well that’s a good question, I think in the past the decisions were made by individual medical boards, and now there’s an Australian Medical Board that sets certain levels of the IELTs testing and AMC exam. It’s different if you want to come and work or study in a university, so the IELT score that’s required is an average of six-point-five, but to work in a hospital and do some training in a hospital, the IELT score required is seven across all bands of the IELT’s test, and that’s a very high bar for people to get.
LAM: But it might be argued though that because communication is vital in healthcare, so healthcare practitioners’ language skills also need to be quite good?
DUKE: They do need to be good Sen, they certainly need to be good if they’re coming to Australia to train. They won’t get anything out of the training if they don’t have good English language skills. But the point is the level of the requirement, and I know many people who are very competent in English, they communicate very well with me and other people in English, and yet they still can’t reach the test requirement.
LAM: So what is it exactly that makes these English tests so hard? I mean for instance are they tested on literature or grammar, or is it just spoken and some written tests?
DUKE: They’re tested on written, spoken, listening and one or two other domains, I’m not too familiar with the exact nature of the test, but they’re of a very high standard and many people from the poorer countries in our region can’t achieve the seven, the IELT score of seven across all bands that’s required to come and work in hospitals.
LAM: And Trevor do you have any suggestions for the different authorities on how to improve the training and indeed the accessibility of training in Australia for these foreign doctors?
DUKE: Well I think the first thing is to separate out the two issues between doctors who want to come here and make their careers in Australia. And I think for those people the requirements may well be appropriate, I have no comment on the requirements to that level, because one would expect a very high standard. I think it’s different though for people who want to come to Australia for six or 12 months or two years of training in a post-graduate area for which they can’t be trained at home. And for those people I think we should have more flexibility, because they’ll be working only in well supervised positions, they’ll be competent doctors already, they’ll often have a post-graduate qualification in their own country. And this is a contribution that Australia really could be making that we’re not making because of these regulations.
LAM: And also in terms of regional leadership I suppose it’s good that these doctors come to train in Australia and they can then go home and train their counterparts and their fellow countrymen?
DUKE: Yes that’s certainly something that’s important. I mean it’s not just the clinical skills that people learn when they come to Australia, it’s a whole lot of other things. In fact most of these doctors who come to Australia have very competent clinical skills. What they learn though are different things; they learn about networks of professionals, they learn about different work ethics, they build sort of networks that stand them in good stead for the rest of their careers and help their role when they go home, and they learn about leadership skills.
LAM: And Professor Duke what are the professional credentials of these foreign doctors? I understand they’re sometimes not checked properly, how did that come about, how does that happen?
DUKE: Well I think that’s a separate issue. I think certainly for some foreign doctors their credentials may not have been well checked in the past, but now there’s a very high level of checking that goes on. I’m really talking about the situations where there is a link between Australian institutions and training institutions in the region. And if there’s a link there then we know what the standards are, and we can help provide some training in linked supervised positions. I’m not talking about the training of anybody who simply wants to come to Australia, that’s a very different situation, for which there must be of course very high credentialing.
LAM: And just very briefly, what developing countries are we talking about here, these foreign doctors who are coming in?
DUKE: Well at the moment it’s a problem of the foreign doctors not being able to come in, rather than those coming in. But if Australia was to make a contribution to the poorer countries in the Asia Pacific region, then you think of the poorer developing countries in which people can do medical training and they can train in a specialty, but they need some assistance. So countries like Papua New Guinea and the Solomon Islands and Fiji and across Asia I think, Cambodia and Laos, East Timor, Australia could make a very substantial contribution to those countries and the training of medical graduates in those countries.