Issue 43 / 17 November 2014

IT does seem to be human nature to put people with similar attributes into groupings to make it easier to give structure to a comment or strategy about them.

The epithet of IMG (international medical graduate) has been derived, in good faith, from a series of previous groupings used to describe doctors who arrive in Australia with overseas qualifications. “Overseas” or “foreign” doctors are favourite descriptions used in the lay press.

IMG is a rather “soft” grouping because, while intended to be generic, it actually avoids discrimination. As a Scotsman arriving in Australia in 1982 with an Australian wife, I actually come under the IMG umbrella, yet I am seldom included in the current debate about IMGs.

Today’s IMGs often come from regions such as Africa, Asia and the Middle East. Some doctors, particularly those from the UK and New Zealand, tend to have less emphasis on their IMG status than others, however unfair that might seem.

Despite federal laws that attempt to stifle discrimination, it is inevitable in real life that ethnicity will rear its ugly head to the disadvantage of many IMGs who have to work harder to be accepted than do those of Anglo-Saxon descent.

This seems to be the human condition which, however odious, would be equally applicable if the movement were the other way around, from here to there.

However, there is no doubt that one of the joys of practising medicine in Australia is the exposure to the fabulously rich cultural diversity in medical, nursing and ancillary staff. There is nothing more rewarding than to work with a buzzing, harmonious group of health care practitioners from half a dozen countries, among whom powerful, lifelong friendships are regularly forged.

However, some IMGs, newcomers to this country, find themselves in isolated, far-flung communities. These outposts are often the last place some IMGs want to be — or indeed should be — but the current system engineers their deposition there.

It is often non-medical sponsors who headhunt overseas doctors and parachute them into a clinic with a computer in a remote town. Rather than feeling part of the community, the driving emotion for the IMG doctor is usually the need to escape.

I visited my good friend Ahmed and asked how he was going in his isolated country town. He said: “Fine, but everyone calls me Mike”. I said: “They are calling you mate”. “But that’s what dogs do!” he said, and so I explained.

I told Ahmed: “Australians swear a lot, generally with no malice, like our use of the term bastard. What do you think that term means?” He replied: “A bastard is a child born out of wedlock”.

“Yes”, I said, “but Australians often use the word bastard in everyday language without intent to insult”.

“Now I understand why my patient called me a poor bastard”, he said.

Getting used to the Australian way can be a lifelong learning experience. The AMA is dedicated to the wellbeing of all its members and it recognises the challenging circumstances of IMGs. Yet, it is not always easy to know who and where IMGs are.

While many IMGs are members of AMA, many others are not, partly because they hold a perception that it is a government or political organisation, which it is not.

AMAQ would love to hear from IMGs with both positive and negative experiences of working in Australia.

It is only by communicating that we, as a profession, might defeat those pernicious prejudices which so inappropriately pervade our health system.
 

Dr Bill Boyd is Chairman of the Queensland branch of the AMA and a gynaecologist based in regional Queensland. AMAQ can be contacted at amaq.com.au

5 thoughts on “Bill Boyd: Being an IMG

  1. Ulf Steinvorth says:

    The AMA QLD chairman openly naming Australia’s international doctors being negatively affected by racism, quite a statement. Sadly followed by a condescending tale about the difficulties of English as a second language which even though undoubtedly a problem for many hardly the main cause of the racism or unfair treatment and near impossible accreditation process in the first place.

    Having worked in numerous anglophile countries including the UK and NZ as a non-native speaker I can reassure Dr Boyd that I have never experieced the same level of racism, ostracism or mistrust towards ‘foreign’ doctos as here in Australia and I would be interested to hear what exactly the AMA has done to fight this illegal discrimination of its members and colleagues because sadly I do not know of any initiatives.

     

     

  2. Tim Lindsay says:

    Yet another article on IMGs. Whilst this is an important issue that deserves some attention, I only wish that the training crisis affecting local junior doctors received half as much publicity. A true disaster is unfolding that far outweighs any other structural problems within the recruitment and training process, IMG issues included. 

  3. Ulf Steinvorth says:

    An article about racism in Ausralian medicine and a response lamenting that ‘local’ doctors do not receive half as much publicity and that their issues far outweigh ‘other’ doctors’ issues in importance. Kinda proves the point of the article, doesn’t it?

    Training crisis might well be a disaster, but surely it is a disaster for all doctors who work and train here, no matter where they were born, where they studied or what skin colour they have.

  4. Tim Lindsay says:

    @Local doctors, as I freely acknowledged, the issues discussed in the article are important and deserve attention. Articles highlighting the barriers faced by IMGs seem to be topical at the moment, with a few pieces of a similar nature appearing across the Australian medical literature. Let’s hope that this, in turn, leads to a more efficient system and fairer conditions for those who migrate to work in Australia.

    However, judging by your comments I think you have blurred and misunderstood my use of the term ‘local.’ By inappropriately introducing ‘racism’, ‘where they were born’ and ‘skin colour’ you confuse the key issue I raised: training pathways for Australian graduates. The fact is there is a fundamental mismatch between the supply and demand of junior positions.  At best, many junior doctors face excessive training times whilst working as service registrars. At worst they face unemployment or the prospect of migrating purely to continue training as a doctor in their chosen field. Despite this unfolding and unmitigated disaster there is little public drive for reform and, in my experience, next to no awareness or sympathy from senior staff.

    My comment was not intended to trivialise the challenges faced by IMGs. However, Australian graduates vastly outnumber IMGs and so, despite your opposition, I do see the training crisis as an issue that outweighs the IMG specific challenges that have received so much attention recently.  Therefore I stand by my comment lamenting the dearth of attention to an issue facing the majority of junior doctors in Australia.

  5. Ulf Steinvorth says:

    @Junior Doctor – your key issue seems to be whether your colleagues trained in Australia or not implying their rights to medical training depend more on where they trained than what work they do and how well they perform on the job.

    I still belive training and working conditions are an issue for all doctors working here, i.e. all local doctors, no matter where they trained or where they were born (which usually affects where you study). Point of the article is that it is much harder for international doctors to access training or to get the same recognition even though most do exaclty the same work. The 2012 parliamentary inquiry into this issue proves this point in fine detail, let me attach just one quote to set the numbers you quote into clearer light:

    ‘While it is difficult to determine exact numbers, the submission from DoHA indicates that IMGs currently comprise approximately 39% of the medical workforce in Australia and 46% of general practitioners in rural and remote locations.’ source: Lost in the Labyrinth Parliamentary report 2012

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