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
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.
ABC
Radio Australia
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