International medical graduate experiences and performance

International medical graduates play a critical role in the health care of Australian communities and make important contributions across a range of areas including as doctors, health service leaders, researchers, teachers and supervisors of other health professionals. International medical graduates bring skills, knowledge and a diversity of experience that adds value to the communities they serve.

We also know that many international medical graduates who want to work as doctors in Australia find the process complex, at times bureaucratic, time consuming, uncertain, expensive and stressful.

The International medical graduate experiences and performance project seeks to:

• better understand the journeys of international medical graduates who are navigating assessment pathways and entry into the Australian medical workforce,
• and to identify strategies that can help resolve some of the long-standing challenges that international medical graduates face.

Through this work, we show the diversity of international medical graduate experience, their contributions to the Australian health system, their challenges, and the individual and system solutions that would improve their journeys.

By working with partners and stakeholders, and listening to international medical graduates, we are moving forward with initiatives to improve assessment pathways and support for international medical graduates undertaking assessment, while ensuring that international medical graduates can practice safely in Australian healthcare settings.

This work has direct relevance to the National Medical Workforce Strategy, Independent review of overseas health practitioner regulatory settings (the Kruk Review) and other reviews aimed at addressing medical workforce shortages and improving access to high-quality medical care for all Australians.

The project draws on data from a survey of international medical graduates, stories shared in focus group sessions and in-depth interviews with health services and international medical graduates, and insights from our cross-sectorial project advisory group.

Recognising that the ecosystem in which international medical graduates practice is complex and involves many stakeholders, the initiatives presented in the Clearing the way report have been categorised according to those that the AMC will lead, those that will require partnership and collaboration with other agencies, and those that the AMC can support.

• We are prioritising those initiatives that the AMC can lead. Learn more about what we are doing about the future of the AMC clinical exam.
• We will continue to work with external stakeholders on cross-sectorial solutions (Partner) and have begun planning.
• We will ensure that the initiatives that have high relevance for the Kruk Review are undertaken in alignment with the final recommendations of the review.

We are developing interactive journey maps and personas that will provide a much richer understanding of the lived and diverse experiences of international medical graduates as they navigate the pathways to working as a medical practitioner in Australia.

• Journey mapping is a method used to map the key milestones, the pain-points and the enablers of a particular process.  It has been used in marketing and customer product development, however, it has not been widely used in medical education.
• Journey maps are often combined with persona development.  Personas are useful because they draw on evidence from interviews, surveys and focus groups to create compelling stories which explore the lived experience of a specific user group.

These methods inform human-centric design and user-centred strategic planning because they allow us to see the challenges and proposed solutions from the perspective of those most closely impacted.  They democratise change and privilege the voice and perspectives of the users of a process and system.

We undertook extensive consultation on the static versions of the journey maps and personas. The valuable feedback that we received from stakeholders will help us to further refine them for the interactive versions. Below are a few quotes. Please download the full consultation report to read more comments.

“It is a great way to educate staff members within the health system that are involved in the recruitment, employment and supervision of IMGs. It highlights the diversity and the unique experiences that impact individuals and their families. It also highlights to IMGs the challenges they and their families will face so that they can make informed decisions regarding relocation to Australia to commence or continue their medical careers.”

“Really well done and gives a human touch to a complex issue. There are so many complexities around the IMG journey and this work shows how many things that need to be considered.”

Some of the challenges that international medical graduates shared with us

Some of the suggested improvements that international medical graduates shared with us

This work is being led by a Project Advisory Group that includes a wide range of stakeholders with broad and deep experience in the assessment, supervision training, support, registration and employment of international medical graduates, and a passion for sharing their knowledge to improve the system.

Project Advisory Group

• Dr Vijay Roach, Chair
• Associate Professor Nicole Mercer, Aboriginal and/or Torres Strait Islander member
• Ms Christine McKeay, Ahpra
• Ms Bernadette Thomson, Ahpra
• Professor Cheryl Jones, AMC Committee Member
• Professor Amanda Barnard, AMC Committee Member
• Emeritus Professor David Prideaux, AMC Committee Member
• Dr Rachael Coutts, AMC Committee Member
• Dr Mandeep Kalsi, AMC Committee & International Medical Graduate member
• Dr Ayaz Chowdhury, Australian Medical Association
• Dr Ian Kamerman, Australian Medical Association
• Dr Kenneth Loon, Bridging Course Provider
• Ms Beverley Sutton, Bridging Course Provider
• Ms Praveen Sharma,  Department of Health and Aged Care
• Dr Susan Wearne, Department of Health and Aged Care
• Assoc Professor Andrew Singer AM, Department of Health and Aged Care
• Dr Kashmira De Silva, Executive staff of health services
• Dr Hùng The Nguyen, Executive staff of health services
• Dr Elizabeth Rushbrook, Executive staff of health services
• Ms Christine Edwards, Health Consumer and Community Member
• Dr Farzad Jazayeri, International medical graduate examiner and supervisor
• Dr Aditee Parab, International medical graduate examiner and supervisor
• Associate Professor Peta-Ann Teague, International medical graduate examiner and supervisor
• Dr Pratish George, International medical graduate member
• Dr Aarons Rogers, International medical graduate member
• Ms Corrine Taylor, International medical graduate recruiter
• Assoc Professor Stephen Adelstein, Medical Board of Australia
• Assoc Professor Jenepher Martin, Medical Education and Research Expert
• Mr Korian Strakosch, Postgraduate Medical Education Council
• Dr Easwaran Krishnan, Workplace Based Assessment Provider
• Dr Ajith Thampi, Workplace Based Assessment Provider

Technical Advisory Group

• Assoc Professor Jenepher Martin, Medical Education Research/Consultant Breast Surgeon
• Dr Shyamsundar Muthuramalingam, Manager Consumer Engagement, SA Health
• Dr Tapan Parikh, Department of Intensive Care, Monash Medical Centre
• Ms Carol Pizzuti, Senior Research Officer, The Royal Australasian College of Physicians
• Professor Robyn Woodward-Kron, Director of Research and Research Training, Department of
  Medical Education, The University of Melbourne

This project has Monash University Human Research Ethics Committee (HREC) approval #37561.