OTDs hamper GP training

The high proportion of overseas trained doctors working in rural general practice is hampering the training of younger GPs, the head of one division says.
Pilbara division of general practice chief executive Chris Pickett says about half the rural GPs in WA are international graduates and most do not have the fellowship qualification from the RACGP to enable them to train future GPs. He tells the West Australian today (link) that the lack of suitable trainers is a major factor in his own region not having any GP trainees this year.
“It’s traditionally where these young kids who want to become doctors get exposure to rural areas to make decisions about whether they will come and work there so it’s a very strong recruitment tool that we’re missing,” he says.
And most overseas trained doctors working in rural practice were so busy they had little time to devote to studying for the RACGP, he adds.
The situation will only get worse as new accreditation regulations come into force this month stipulating that all overseas trained doctors pass the AMC exam, he predicts.
A spokesman for the Rural Doctors Association of Australia confirms the lack of doctors to supervise GP trainees and registrars was a significant problem.
“Karratha used to be a place where young doctors would come and do their training and then stay and that was a very important part of the local workforce, that’s fallen off,” he says.16 July 2008
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The lack of training for GP registrars in the Pilbara region is nothing to do with the IMG's who go to work in these areas, it is a direct result of Australian doctors with the FRACGP choosing not to work in these areas.
IMG's in many areas are doing jobs the local doctors won't do and they should be thanked for that. It is far too easy to blame the IMG for everything that is wrong with rural general practice. Remember we can only work in "areas of need" where there are vacancies not filled by Australians, or are we to blame for the 56 GP vacancies across WA too?
Posted by Dr Nicki Murdock FRACGP and IMG 16/07/2008 4:33:37 PM
I am a IMG with huge experience as GP and teaching medical students and nurses in Zimbabwe. But as soon I came to Australia I am not a good doctor as I haven't pass the FRACGP yet.The authority should look into that.I am sure we can work together to improve the situation.
Posted by Neyamul Bashir 16/07/2008 7:34:22 PM
I apologize but I don’t follow the logic? There are not enough Australian trained doctors to provide clinical care to patients. Consequently, IMGs are recruited to provide essential services to patients and support those Australian trained doctors in delivering patient care. The issue is NOT that the presence of IMGs are hindering the training of rural doctors . The issue is the shortage of doctors and the accreditation requirements of the RACGP which I would hinder the recruitment of appropriately trained GP trainers. Mine is a case in point. I am a vocationally trained GP with 15 years clinical and academic experience. In fact I was recruited to come to Australia to teach the next generation of doctors. Yet, I would not be deemed eligible to train your RACGP fellows because I do not have my RACGP. This is not an uncommon situation. This is yet another example of somehow twisting the facts to focus on IMGs when the issues have little to do with IMGs and are the result of a highly dysfunctional registration and accreditation system. Another error is that the IMGs do not need to sit the AMC exam. The new screening exam is run by the AMC but is a different exam and was designed for different reasons. In case I am accused of talking off the top of my head I have recently extensively researched this issue for an article that I have written on the Australian accreditation and registration system
Finally, Australia is having increasing difficulties getting IMGs to come to this country because it is viewed as very IMG unfriendly and articles such as this will only serve to exacerbate these negative impressions. If you think things are bad now just wait until there is a further drop off in this internationally highly sought after valuable resource – IMGs.
Dr. Sue Douglas
Senior Lecturer,
Academic Unit of General Practice and Community Health,
Australian National University,
Posted by Dr. Sue Douglas 16/07/2008 11:07:43 PM
View As Web Page
“Reap what you Sow”
Please don’t ask me to feel sorry for the RACGP who are now reportedly struggling to find supervisors / trainers for registrars in Australia. Who says that you need an FRACGP to be a good supervisor? – well funny that – it was the RACGP in mid 1998 who changed the rules wherein an FRACGP was a required pre-requisite to be a supervisor and everyone without it, who’d been happily and successfully training registrars for years, was deemed no longer acceptable to the holy college.
Historically we’d argued for years as rural gp’s to be allowed to participate in the college training program to no avail, then in early 1994 during negotiations with the feds, the college for political reasons had to be able to show a rural interest. Around that time I received a call from the RACGP who were suddenly enthusiastic for me to sign on as a supervisor. The only condition was that I had to sign up within a matter of days, as they needed to be able to demonstrate a certain level of rural placements for registrars. All went v well until early 1998 when non FRACGP’s were suddenly deemed no longer acceptable and we were told no more registrars.
Why you may well ask? – Had there been some new evidence based data proving that FRACGP’s were better supervisors?

No - the RACGP was under pressure from their metropolitan members / supervisors. The number of registrar positions nationally had been reduced from 900 or so to 400 and their metropolitan members were no longer guaranteed a continuum of registrars every six months.

Overnight the college turned their back on their commitment to rural placements. 1998 was also the year I left true rural practice and also the year I turned my back on the college.
Russell Wiseman
Sunshine Coast
Queensland.
Posted by Russell Wiseman 16/07/2008 11:09:12 PM
I don't think it is the OTD's that are hampering the GP training. It is the system that does not allow OTD's without fellowship qualification from the RACGP to train GP's. A fellowship qualification from the RACGP does not transform an OTD into some kind of a super doctor and a GP trainer. It only satisfy the system. Some of the OTD's I know are far more experienced, competent and better GP trainers than many Australian trained doctors. It is illogical and ludicrous to say that OTD's hamper GP training.
Posted by Dr Shiva 16/07/2008 11:10:00 PM