‘Discrimination from the start’: Top GP’s despair at treatment of IMGs

Australia is lucky to have them, not the other way around, says Associate Professor Ayman Shenouda.
Associate Professor Ayman Shenouda.

Australia is lucky that doctors from overseas want to work here, yet IMGs are treated like they are the ones who must show gratitude, says former RACGP vice-president Associate Professor Ayman Shenouda.  

The RACGP GP of the Year in 2009, a practice owner of two clinics who was acting RACGP president for four months, Professor Shenouda has written his own success story as an IMG after gaining his medical degree in Egypt.

But he despairs about how little has changed for IMGs in the past 20 years.

He says Australia continues to take the benefits of other countries investing in medical training while its own Treasury fails to support IMGs once they arrive.  

“I want IMG training to be comparable to the Australian GP training program,” he says. 

“Design a program and pay money for a program to get IMGs up to scratch where they are comfortable with their training, the supervisors are comfortable with the training them and practices are well paid. 

“Why can’t Australia be brave enough to look after IMGs the way we look after our own registrars?” 

The RACGP launched the Practice Experience Program back in 2019 to provide mentorship and workplace assessments for IMGs striving towards fellowship, with the Federal Government covering 80% of the funding. 

But in 2022, the government funding was cut.

Professor Shenouda says IMGs may wait 12-18 months for AHPRA and Department of Home Affairs approvals to let them practise, then have to pay $30,000-$40,000 out of their own pockets for training.

“Australia discriminates against IMGs from the start.” 

He says Australia “needs to treat IMGs as if we are lucky to have them”.

“Instead, we treat them as if they need to come here because it is a better opportunity for them, and it is their lucky day when they land in Australia.” 

He also wants more support for practices that supervise IMGs — including his own — saying the only incentive now is a “moral incentive”. 

The IMGs he has recruited have all required level-one supervision, meaning they must consult their supervisor on the management of all patients before the patient leaves the practice, yet supervisors are not remunerated for this work.

On top of this, practice owners work under the assumption that IMGs will leave once they are permitted to practise independently.

“We spend a lot of time and effort to get them up to scratch, and then they leave and go back to the cities,” says Professor Shenouda, who works in Wagga Wagga. 

“The system is not fair to anyone.  

“We need a fresh look on the premise that Australia needs IMGs, and we depend on them to treat our patients.” 

That includes a review of supervision levels for IMGs, he says.  

“In this country, we downgrade IMGs to the level of a medical student, but we want them to deliver in very remote, very difficult situations. That is unfair. 

“I agree they have different levels of education, but all they need is a top-up, not starting from scratch as we do now.” 

“If Australia does not need IMGs, do not get them,” he adds. 

“But now, our health system still depends on them. We need to support them and trust in their capacity.” 

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