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Close 457 loophole for junior doctor positions: AMA

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Hospitals and health departments should be forced to prove they attempted to fill junior doctor vacancies locally before being allowed to hire practitioners from overseas, according to the AMA.

Urging a shake-up of current 457 visa arrangements, the AMA said the recruitment of large numbers of doctors from overseas to fill junior doctor positions in hospitals was no longer tenable given the pressure on training places for local medical graduates.

Even as swelling numbers of domestic medical graduates struggle to secure internships and prevocational training places, official figures show many health authorities and hospitals continue to recruit heavily from overseas, potentially displacing locally trained junior doctors and preventing them from undertaking the additional training they need to complete their qualifications.

In its submission to the Independent Review of the 457 visa program, the AMA cited official figures showing around 2000 doctors entered Australia on 457 visas last financial year, and said it was aware that 916 resident medical officer (RMO) positions were filled by 457 visa holders in the same period.

“While some of these RMOs will be temporary residents that studied medicine in Australia and may seek permanent residency, it appears that many have been recruited directly from overseas,” the AMA said. “This is potentially limiting employment and training opportunities for domestic medical graduates.”

The pressure on medical training places is intensifying. Last year, just 3125 intern places were available to meet the needs of 3300 domestic and international full fee paying medical graduates, and the number of such graduates is projected to reach 3824 by 2017.

Health Workforce Australia predicts there will be a shortage of 450 first-year advanced vocational training positions a year from 2016, placing even more pressure on RMO positions, forcing junior doctors to wait even longer to enter vocational training.

Under current immigration arrangements, employers can sponsor medical practitioners from overseas on 457 visas – including international graduates of Australian medical schools – without having to demonstrate that they have tried to recruit locally first.

The AMA said this exemption from labour market testing was not justified, and should be scrapped.

“It is untenable that substantial numbers of doctors continue to be recruited directly from overseas into intern and RMO positions when a ready supply of local graduates appears to be available,” the Association said.

It said some State and Territory health departments and hospitals did not appear to be using the 457 visa as intended.

“The 457 visa is intended to fill workforce gaps, not displace locally training and highly skilled junior doctors…particularly at a time when domestic medical graduates are struggling to get access to essential training places,” the AMA submission said.

The Association said it valued the contribution that international medical graduates have made, and continue to make, but added that it was incumbent on State and Territory health departments and hospitals to help build a sustainable domestic medical workforce.

“The number of domestic medical graduates is projected to grow even further and, in these circumstances, the current exemption [from labour market testing] cannot be justified,” the AMA said.

The Review is due to report by the end of June this year.

Adrian Rollins