The Royal Australasian College of Surgeons (RACS) has joined other major medical bodies in calling for a pause on the Australian Health Practitioner Regulation Agency’s (AHPRA) plan to fast-track overseas-trained doctors into the Australian healthcare system. The College argues that the proposal, designed to address workforce shortages, is a short-term fix that could jeopardise patient safety and fail to meet the needs of rural and regional communities.
RACS, a leading voice in the medical field, voiced its concerns in a letter to the Federal Health Minister on 11 October, outlining the risks associated with the expedited pathways for Specialist International Medical Graduates (SIMGs). According to RACS President Associate Professor Kerin Fielding, while the initiative aims to address healthcare shortages, the fast-tracking approach is fraught with risks, particularly in regions where proper oversight and support structures are lacking.
One of the main concerns highlighted by RACS is the proposed reduction in the supervision period for overseas-trained doctors. Under the current proposal, SIMGs would undergo a six-month supervision period before being allowed to practise independently. However, RACS argues that this timeframe is too short to adequately assess whether a surgeon is prepared to work safely in the Australian healthcare system, particularly in complex procedural fields like surgery.
RACS believes that reducing the supervision period risks undermining the rigorous training and assessment processes that Australian doctors undergo, potentially compromising the quality of care. Associate Professor Fielding warns that the reduced supervision could lead to inconsistencies in surgical standards, which may put patient safety at risk.
A key aspect of the current debate revolves around the distribution of the healthcare workforce, with rural and regional areas in Australia facing significant shortages of medical professionals, particularly specialists. RACS has long advocated for targeted reforms to grow the surgical workforce in these underserved areas but argues that AHPRA’s proposal lacks a strategic plan to retain SIMGs in these regions.
The College expressed concerns that overseas-trained doctors placed in isolated rural locations may not receive the necessary support and supervision, further exacerbating the standard-of-care disparities between metropolitan and rural areas. Without proper support, the SIMGs may face challenges in maintaining surgical standards and integrating into the Australian healthcare system, ultimately affecting the quality of care provided to patients in these regions.
RACS is also concerned that the fast-tracking initiative could create a two-tier workforce, where SIMGs may not meet the same training and accreditation standards as Australian-trained doctors. The College argues that the current proposal risks undermining the rigorous processes in place to ensure that surgeons in Australia meet high professional and safety standards.
In response to AHPRA’s proposed changes, RACS is advocating for a more strategic and transparent approach to addressing healthcare shortages and are calling for the following actions from AHPRA:
- Pause the implementation – halt the expedited pathways until further consultation and reviews can occur to ensure patient safety and workforce distribution are adequately addressed.
- Targeted recruitment and retention – introducing specific measures to recruit and retain surgeons in rural and regional areas, focusing on geographical and specialty needs.
- Clear qualification criteria and supervision models – need for transparency around qualification requirements as well as supervision and assessment processes to ensure that SIMGs can safely integrate into Australia’s healthcare system.
Despite its concerns, RACS remains committed to working collaboratively with AHPRA, the Medical Board of Australia, and other stakeholders to find a solution that balances workforce needs with patient safety. The College recognizes the need for innovative approaches to address workforce shortages but believes this must be done without compromising the high standards of surgical practice and training in Australia.
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