Survey report illuminates journey of international medical graduates in Australia

The Australian Medical Council (AMC) has released a comprehensive survey report capturing the experiences of more than 4,000 international medical graduates who have or are navigating the various pathways to practice as doctors in Australia.

Key findings

Process delays

• The journey to practice in Australia is often complicated by unclear information on pathways and slow processes with little coordination between agencies. This then leads to delays in getting skilled doctors into jobs and providing medical care.
• Standard Pathway:¹ 77% of participants took more than a year to complete. Main reasons for delays were passing the AMC clinical exam and getting a job so they could apply for limited registration.
• Specialist Pathway: 62% of participants took more than a year to complete. Main reason cited for delay was assessment of comparability.
• A slow and complicated process can mean that international medical graduates give up on their plans to work as doctors in Australia and the health system loses much needed medical practitioners.

Career impacts

• More than two thirds of respondents were interested in further training but 47% felt that the likelihood of being accepted into a training program was low.
• Specialists considered that their qualifications were not sufficiently valued, and that the Australian community was being deprived of the benefits of their expertise.

Family impacts

• Coming to Australia imposed sacrifices on family members, and this made the journey more difficult.
• Over half (52%) of respondents spent more than a year apart from family.

The survey explored the journeys of international medical graduates, the supports and obstacles they faced and gathered feedback on improvements, revealing a complex and challenging experience for many international medical graduates.

“International medical graduates are a vital part of our medical workforce and make significant contributions to communities, especially in regional and remote areas,” said Professor Cheryl Jones, AMC Director and Chair of the AMC Assessment Committee. “We acknowledge the complexity and challenges within the system. As the authority assessing international medical graduates, we are committed to ensuring that we have good systems and processes in place to improve the experience for international medical graduates navigating AMC assessment, while maintaining the highest possible standards to protect the health of the Australian community.”

“What emerges from the survey data, is that the challenges international medical graduates experienced and ultimately whether they felt satisfied with their work and the decision to come to Australia was often influenced by where they were in terms of their career trajectory, whether they had families, their motivations for coming to Australia, and whether or not they felt valued in their workplaces,” said Professor Jones.

Impacts and key themes

• Lost opportunities: Survey respondents are keen to become part of the healthcare community and believe that their skills can make a difference. International medical graduates felt that delays in completing pathways and limitations on progressing their careers ultimately add up to a loss for the Australian community.
• The ten-year moratorium: Legislation that requires international medical graduates to work in areas such as designated priority areas and areas of district workforce shortage was seen by many as creating hardship. International medical graduates felt the policy led to professional isolation and family and career difficulties. Some also felt that the policy was unfair and discriminatory.
• Discrimination, racism and sexism: More than half of the respondents reported experiencing discrimination, including what they saw as preferences for Australian-trained doctors in workplaces, sexism, especially among female international medical graduates, and institutional bias related to the moratorium.
• Family impact: Many felt that having to work in isolated locations made it difficult for families. The factors contributing to Isolation and separation were job location or long processing times.

International medical graduates also shared suggestions to improve their journeys, including streamlining and simplifying processes, lowering costs of assessment and registration, changing the moratorium, expanding resources and support, and increasing international medical graduate representation in decision-making.

Many of the challenges and solutions highlighted in the survey reflect broader issues that have been identified in several government-initiated workforce reviews including the “Working Better for Medicare Review” which is examining the Moratorium, and the “Independent review of health practitioner regulatory settings”, also known as the Kruk Review, which is aimed at streamlining health practitioner regulation to ease workforce shortages in critical areas and improve the journey for international medical graduates.

“The AMC is committed to working with stakeholders to meet the expectations set by the Kruk review,” said Professor Jones. “This includes contributing to the work by the Medical Board of Australia, Ahpra and the specialist colleges to develop an expedited pathway for specialist international medical graduates in general practice and other specialities.”

To further support workforce reforms, the AMC has recently changed the pass mark for the AMC’s clinical exam which will increase the number of qualified doctors entering the workforce while maintaining patient safety. Additionally, a new AMC test centre for the AMC clinical exam will open in 2025 which will increase testing capacity.

Ongoing AMC initiatives

These are part of a number of initiatives that the AMC is leading to improve the experience and support for international medical graduates. Others include:

• Reforming the clinical exam so that it’s fit for purpose now and into the future, taking into account the cost, time and equity for international medical graduates.
• More resources to support exam preparation and integration into the Australian healthcare system.
• Enhancing international medical graduate representation in decision-making, including creating two new international medical graduate positions on the AMC Council to bring firsthand perspectives to policy and strategic direction.

The survey is part of a broader piece of work that the AMC is doing to better understand the experiences of international medical graduates. The AMC has also developed evidence-based personas and journey maps that draw on the survey results and storytelling methods to set out the challenges and possible solutions to improve international medical graduate experiences.

¹ The primary route for general registration

Media Contact: 

Rachel Ippoliti
Communications Manager, Australian Medical Council
E: communications@amc.org.au