House of Representatives Committees

| House of Representatives Standing Committee on Health and Ageing

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Lost in the labyrinth: Report on the inquiry into registration processes and support for overseas trained doctors

19 March 2012

© Commonwealth of Australia 2012
ISBN 978-0-642-79627-1 (Printed version)
ISBN 978-0-642-79628-8 (HTML version)

View the report as a single document - (PDF 2800KB)

View the report as separate downloadable parts:

Preliminary Pages (PDF 208KB)



Chapter 1 Conduct and context of the inquiry (PDF 118KB)

Conduct of the inquiry
Scope of the inquiry
Context of the inquiry
A complex system
The National Registration and Accreditation Scheme
Previous inquiries
Structure of the report

Chapter 2 Australia’s medical workforce (PDF 167KB)

Medical practitioner supply
International medical graduates or self sufficiency
Committee comment
Australia’s medical workforce policy
Targeted programs
Non-targeted programs
Other initiatives
State and territory governments
Medical Workforce Planning
COAG and medical workforce planning
Health Workforce Australia
Committee comment

Chapter 3 Accreditation, registration and other processes (PDF 275KB)

Primary source verification of qualifications and proof of identity
AMC pathways to registration
The Competent Authority Pathway
The Standard Pathway (2-part assessment)
The Standard Pathway (Workplace-based Assessment)
Specialist assessment
The Specialist Pathway (Full Recognition)
The Specialist Pathway (Area of Need)
Categories of registration
General Registration
Provisional Registration
Limited Registration
Specialist Registration
Registration requirements
Proof of identity
Evidence of qualifications
Registration and work history
Employment information
Other registration requirements
Pathway specific requirements
Registration renewal
Registration renewal for Limited Registration
Other processes
Obtaining a visa
Visa options
Permanent residency options
Temporary residency options
Accessing Medicare practitioner benefits
Section 19AB of the Health Insurance Act 1973
Finding employment

Chapter 4 Issues with accreditation and assessment (PDF 285KB)

AMC accreditation and assessment
Primary source verification
Committee comment
Competent Authority Pathway
Competent Authority recognition
Committee comment
Standard Pathway (2-part assessment)
Part 1 – Multiple Choice Question examination
Part 2 – Structured Clinical Examination (SCE)
Committee comment
Committee comment
Targeted level of AMC examinations
Committee comment
Standard Pathway (Workplace-based assessment)
Committee comment
Specialist medical college processes
Assessing level of comparability
Distinctions between levels of comparability
Recognition of prior training and experience
Peer review
Committee comment
Specialist medical college examinations
Competence level of college examinations
Committee comment
Reconsideration, review and appeal of college decisions
Committee comment
Perceptions of assessment and accreditation authorities
Committee comment

Chapter 5 Issues with registration and associated processes (PDF 306KB)

Demonstrating clinical competency
Peer review and clinical supervision
Availability of clinical supervisors
Committee comment
Skills and training of clinical supervisors
Committee comment
Pre-Employment Structured Clinical Interview (PESCI)
Committee comment
English language skills
Difficulty in achieving the English Standard
Academic focus of the English Standard
Committee comment
Two year validity of test results
Committee comment
Processes adjacent to registration
Immigration and registration
Provision of data for immigration decision making
Committee comment
Deregistration of temporary resident international medical graduates
Committee comment
Classifying areas of workforce shortage
Districts of Workforce Shortage (DWS) and Areas of Need (AoN)
Committee comment
Utility of the 10 year moratorium
Committee comment

Chapter 6 Improving administrative efficiency (PDF 311KB)

Recruitment timeframes
Committee comment
Maintaining Limited Registration
Committee comment
Administration of the National Registration and Accreditation Scheme
Transition to the National Registration and Accreditation Scheme
Committee comment
Responding to inquiries
Committee comment
Documentation requirements and processing
Committee comment
Committee comment
Document validity
Committee comment
Application and assessment fees
Committee comment
Grievances, complaints and appeals
Administrative complaints
Committee comment
Dealing with allegations bullying and harassment
Committee comment

Chapter 7 Support for International Medical Graduates and their families (PDF 252KB)

Stages of support
Clinical and professional orientation
Cultural awareness training
Committee comment
Ongoing support
Educational support and professional development
Examination preparation
Peer support and mentoring
Committee comment
Access to educational and training support
Committee comment
Personal and family support
Committee comment
Navigating the system
One-stop shop and case management
Committee comment
Accessing information
Committee comment

Appendix A – List of submissions (PDF 54KB)
Appendix B – List of exhibits (PDF 70KB)
Appendix C – Other documentary evidence (PDF 62KB)
Appendix D – List of public hearings (PDF 70KB)

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