The Medical Board of Australia is currently undertaking a series of consultations on pathways for international medical graduates (IMGs), seeking input and feedback to proposals to:
- Streamline the Specialist pathway
- Formalise the Competent Authority pathway and;
- Review the Standard pathway
Full discussion papers on each of the consultations are available here.
Streamlining the Specialist Pathway
While the current pathway is largely college-led at the front end, the draft proposal would make AHPRA / the Medical Board the single-entry point, with colleges still assessing specialist qualifications, training, experience and competence but providing advice into a Board-led registration process. The proposal does not remove the need for specialist assessment. SIMGs would still need to demonstrate that specialist qualifications, training, experience and competence are suitable for Australian specialist practice and colleges will still be central to that assessment. It also does not replace the Expedited Specialist pathway. The streamlined Specialist pathway is for most SIMGs who are not eligible for the Expedited Specialist pathway accepted qualifications list. Main changes include:
- SIMGs apply to Ahpra as the single-entry point, as opposed to applying through relevant specialist medical colleges as they do currently
- Colleges maintain a critical role in assessment of qualifications, training, experience and competence, reporting to the Board through approved frameworks
- The Board’s role as formal decision maker would be strengthened, responsible for SIMG eligibility and registration informed by college advice.
- Specialist medical college Standards for assessment of IMGs in place since 2021 will be replaced by new Specialist pathway requirements.
- Instead of individual college assessment and fees, this proposal looks to apply greater consistency across specialities through standardised, Board-approved assessment frameworks, reporting templates and advice requirements. The aim is to make pathway requirements clearer, more consistent and more transparent.
- Colleges will advise the Board on required supervised practice, upskilling, suitable positions and competency assessment for specialist registration.
- SIMGs will be able to work concurrently toward specialist registration granted by the Board and specialist qualification/fellowship awarded by a relevant college
- The proposal aims to improve the clarity of process, reduce duplication and improve system-wide efficiency across the system.
Formalising the Competent Authority Pathway
This proposal is mostly a codification and clarification exercise, not a major redesign of the Competent Authority pathway. The Board is proposing to move the current pathway requirements, which are now spread across website pages and guidance documents, into a formal registration standard approved under the National Law. The aim of the change is to improve clarity, transparency, consistency and certainty for IMGs, employers and decision-makers.
The Competent Authority pathway already exists. It is for IMGs who have been assessed by, or trained in, a recognised competent authority system. The current competent authority countries/systems include the UK, Ireland, New Zealand, USA and Canada, with seven current categories. The Board’s proposal has four main elements:
- Formalise the existing pathway in a registration standard.
- Make minor changes to eligibility criteria, particularly for certain UK/GMC offshore internships.
- Clarify supervised practice requirements, including that the Australian supervised practice must be clinical practice.
- Introduce an explicit Aboriginal and Torres Strait Islander cultural safety education requirement.
Review of the Standard Pathway
The new draft standard “General Registration for international medical graduates on the standard pathway” proposes to replace the current Registration standard: Granting general registration to medical practitioners who hold an Australian Medical Council certificate. The draft standard does not propose significant changes, retaining the core pathway of AMC assessment/certificate plus supervised practice in Australia before general registration.
The main differences include:
- Change of name for the standard to better clarify its purpose and better distinguish it from the Competent Authority Pathway.
- Adds a new alternative to current requirements for supervised practice (currently 47 weeks FTE supervised practice in Australia incl. 10 weeks medicine, 10 weeks surgery, 8 weeks emergency plus other supervised experience) of 47 weeks FTE of accredited PGY1 training if available.
- Updates the reference point to the AMC National Framework for PGY1 and PGY2 Medical training to include the updated PGY1 outcomes introduced from 2024.
- While orientation is already a requirement for IMGs holding provisional or limited registration, the new standard makes it an explicit requirement to complete board-approved orientation to the Australian healthcare system AND Aboriginal and Torres Strait Islander cultural safety education before general registration.
- Retains but further clarifies flexibility where an IMG cannot complete all core rotations
Submissions to the proposals are due on 27 July for the Specialist Pathway changes and 31 July for the Competent Authority and Standard pathways. RCSA and AMRANZ are inviting member feedback on the proposals. Feedback can be provided either directly or to RCSA’s advocacy team at [email protected] to help inform RCSA/AMRANZ response to the proposals.