Aniello Iannuzzi: Take the IMG challenge

WOULD you swap places with an international medical graduate hoping for registration in Australia? Certainly not!

And would you want to be a rural practice that needs an IMG to relieve workforce pressures? Unfortunately, that’s my practice.

I have been stuck in a horrible workforce crisis for the past 6 months. For the first time in 15 years, I have not had an assistant, associate or registrar to help at my practice.

There have been some benefits of flying solo, such as reconnecting with patients I have not treated for some time and not having to field numerous calls from registrars for advice. However, I do prefer the camaraderie and time flexibility that group practice brings.

For those of us in small towns, changes to the rural incentives program — the subject of many articles in the medical press in the past 2 years — have seen us shunned by doctors who now can enjoy all the benefits of holiday resort towns or large regional centres while pocketing large rural retention payments.

And since rural rotation is no longer compulsory for GP registrars — General Practice Registrars Australia persuaded government that an outer urban term is just as good — the workforce drought for small towns has never been as bad.

I am sure many GP registrars, regional training providers and government officers will say that all is fine and dandy, and will produce statistics to support their case. However, we need to dissect the figures and look at the situation town by town to see the real impact.

The solution for many rural GPs is to recruit an IMG. Unlike a registrar, an IMG under an “area of need” program can stay for a few years, particularly because almost all of them are on moratoria of 5–10 years in an area of need as part of their immigration conditions.

While the only contact most doctors will have with the Australian Health Practitioner Registration Agency (AHPRA) is paying a hefty registration fee once a year, the whole IMG experience brings you up close to this very impersonal organisation.

AHPRA was born in 2010 as part of the push for national registration and accreditation. Most of us swallowed the bait, as national registration sounded so appealing — one registration fee and form and you can work anywhere in Australia. It sounded good, so not many complained.

The sting is in the accreditation side, as the IMGs and their sponsors know.

I have had to fill in so many forms to get an IMG to work for me that I have lost track of how many pages my printer has spat out just for this in recent months … and I am still waiting for help.

Some of the questions I have been asked are not unreasonable — details about the IMG, the sponsor, the employer and the supervisor, a job description, the contract or job offer and hours of work.

Other questions do push the friendship, such as those about the town’s demographic mix and medical services. These questions make you wonder about relevance and why the government doesn’t already have most of this information.

And then the bit that really gets under your skin. These same questions and similar forms, with minor variations, have to be submitted to the following:

• State government for an area of need application

• Department of Health and Ageing for access to district of workforce shortage

• Medical Board of Australia supervised practice plan and principal supervisor’s agreement

• Medical Board of Australia application for limited registration for an area of need

• Medical Board of Australia application for limited registration for postgraduate training or supervised practice

Virtually the same questions, virtually the same forms, FIVE times!

At least we now know where the money from registration fees goes.

Meanwhile, my patients and I are still waiting for some help …

Dr Aniello Iannuzzi is a GP practising in Coonabarabran, NSW.

Posted 25 June 2012